Severe mucocutaneous HSV lesions respond best to initial treatment with intravenous (IV) acyclovir (AIII).5,17 Patients can be switched to oral antiviral therapy after their lesions have begun to regress. Genital herpes is a chronic, life-long viral infection. Cell culture and PCR are the preferred HSV tests for persons who seek medical treatment for genital ulcers or other mucocutaneous lesions. Even persons with first-episode herpes who have mild clinical manifestations initially can develop severe or prolonged symptoms. Intravenous (IV) acyclovir therapy should be provided for patients who have severe HSV disease or complications that necessitate hospitalization (e. Initial empiric therapy for HIV-infected children with suspected intravascular catheter sepsis should target both gram-positive and enteric gram-negative organisms, with combinations that have activity against Pseudomonas spp. Children or adolescents with severe immunosuppression and moderate-to-severe mucocutaneous HSV lesions should be treated initially with IV acyclovir and may require longer therapy (AI ).
Primary HSV infection in patients treated for leukemia is unusual, and antiviral drug prophylaxis is thus not recommended in HSV-seronegative leukemic patients during chemotherapy or after SCT (DIII). Intravenous acyclovir remains the therapy of choice for severe mucocutaneous or visceral HSV disease in immunocompromised cancer patients. In a randomized, placebo-controlled trial of i.v. acyclovir therapy for mucocutaneous HSV disease, including various immunocompromised hosts, acyclovir significantly shortened the periods of virus shedding and lesion pain, and induced more rapid lesion scabbing and healing. Initial infection with P. jirovecii usually occurs in early childhood; two thirds of healthy children have antibody to P. Alternative therapeutic regimens for mild-to-moderate disease include 1) dapsone and TMP (BI)136,147 (this regimen might have similar efficacy and fewer side effects than TMP-SMX but is less convenient because of the number of pills), 2) primaquine plus clindamycin (BI)148-150 (the clindamycin component can be administered intravenously for more severe cases; however, primaquine is only available orally), and 3) atovaquone suspension (BI)135,151 (this is less effective than TMP-SMX for mild-to-moderate disease but has fewer side effects). Severe mucocutaneous HSV lesions respond best to initial treatment with IV acyclovir (AII)734,738. The Committee for Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections of the Korean Society for AIDS was founded in 2011.
A 57-year-old male with severe renal disease presents with acute coronary syndrome. Which one of the following is most appropriate for the initial treatment of claudication? Good evidence for lack of efficacy or for adverse outcome supports a recommendation against use. Dosages for prophylaxis to prevent recurrence of opportunistic disease in HIV-infected adults and adolescents are given in Table 2 (page 774), dosages to prevent recurrence in infants and children are given in Table 3 (page 776) and criteria for discontinuing and restarting prophylaxis for opportunistic infections in adults with HIV infection are given in Table 4 (page 778). Amphotericin B, 1.0 mg per kg IV weekly (AIII); itraconazole, 2 to 5 mg per kg orally every 12 to 48 hours (AIII). In patients who have frequent, severe recurrences of genital HSV disease, acyclovir prophylaxis might be indicated (BIII). Varicella Eruption (Eczema herpeticum). iv) Severe primary HSV infections (eg.