Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS

Ann Gateley, Rita M. Gander, Philip C. Johnson, Saul Kit, Haruki Otsuka, Steve Kohl

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

A case is reported of relapsing fatal meningoencephalitis caused by a neurovirulent thymidine kinase-positive (TK+) type 2 herpes simplex virus (HSV) that developed thymidine kinase deficiency (TK-) during intravenous acyclovir therapy. A patient with AIDS was admitted for acyclovir treatment of a persistent perirectal herpetic ulcer. He subsequently developed meningoencephalitis. A TK+ type 2 HSV was isolated from a brain biopsy specimen. A progressive and fatal relapse occurred, and a TK- type 2 HSV was isolated from his cerebrospinal fluid. Restriction endonuclease analysis of viral DNA from perianal, brain, and cerebrospinal fluid isolates were similar, suggesting that they were the same viral strain. Animal virulence studies indicated significant cutaneous virulence in immunocompromised mice models for the TK- isolates. This case is notable because TK- HSV have, in the past, lacked neurovirulence and because acyclovir resistance developed during therapy and caused the patient's death.

Original languageEnglish (US)
Pages (from-to)711-715
Number of pages5
JournalJournal of Infectious Diseases
Volume161
Issue number4
StatePublished - Apr 1990

Fingerprint

Herpes Simplex Encephalitis
Human Herpesvirus 2
Acyclovir
Thymidine Kinase
Acquired Immunodeficiency Syndrome
Meningoencephalitis
Simplexvirus
Virulence
Cerebrospinal Fluid
DNA Restriction Enzymes
Viral DNA
Brain
Ulcer
Therapeutics
Biopsy
Recurrence
Skin

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS. / Gateley, Ann; Gander, Rita M.; Johnson, Philip C.; Kit, Saul; Otsuka, Haruki; Kohl, Steve.

In: Journal of Infectious Diseases, Vol. 161, No. 4, 04.1990, p. 711-715.

Research output: Contribution to journalArticle

Gateley, A, Gander, RM, Johnson, PC, Kit, S, Otsuka, H & Kohl, S 1990, 'Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS', Journal of Infectious Diseases, vol. 161, no. 4, pp. 711-715.
Gateley, Ann ; Gander, Rita M. ; Johnson, Philip C. ; Kit, Saul ; Otsuka, Haruki ; Kohl, Steve. / Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS. In: Journal of Infectious Diseases. 1990 ; Vol. 161, No. 4. pp. 711-715.
@article{5028a7c12b474374b7d292d3c584a1b3,
title = "Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS",
abstract = "A case is reported of relapsing fatal meningoencephalitis caused by a neurovirulent thymidine kinase-positive (TK+) type 2 herpes simplex virus (HSV) that developed thymidine kinase deficiency (TK-) during intravenous acyclovir therapy. A patient with AIDS was admitted for acyclovir treatment of a persistent perirectal herpetic ulcer. He subsequently developed meningoencephalitis. A TK+ type 2 HSV was isolated from a brain biopsy specimen. A progressive and fatal relapse occurred, and a TK- type 2 HSV was isolated from his cerebrospinal fluid. Restriction endonuclease analysis of viral DNA from perianal, brain, and cerebrospinal fluid isolates were similar, suggesting that they were the same viral strain. Animal virulence studies indicated significant cutaneous virulence in immunocompromised mice models for the TK- isolates. This case is notable because TK- HSV have, in the past, lacked neurovirulence and because acyclovir resistance developed during therapy and caused the patient's death.",
author = "Ann Gateley and Gander, {Rita M.} and Johnson, {Philip C.} and Saul Kit and Haruki Otsuka and Steve Kohl",
year = "1990",
month = "4",
language = "English (US)",
volume = "161",
pages = "711--715",
journal = "The Journal of infectious diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS

AU - Gateley, Ann

AU - Gander, Rita M.

AU - Johnson, Philip C.

AU - Kit, Saul

AU - Otsuka, Haruki

AU - Kohl, Steve

PY - 1990/4

Y1 - 1990/4

N2 - A case is reported of relapsing fatal meningoencephalitis caused by a neurovirulent thymidine kinase-positive (TK+) type 2 herpes simplex virus (HSV) that developed thymidine kinase deficiency (TK-) during intravenous acyclovir therapy. A patient with AIDS was admitted for acyclovir treatment of a persistent perirectal herpetic ulcer. He subsequently developed meningoencephalitis. A TK+ type 2 HSV was isolated from a brain biopsy specimen. A progressive and fatal relapse occurred, and a TK- type 2 HSV was isolated from his cerebrospinal fluid. Restriction endonuclease analysis of viral DNA from perianal, brain, and cerebrospinal fluid isolates were similar, suggesting that they were the same viral strain. Animal virulence studies indicated significant cutaneous virulence in immunocompromised mice models for the TK- isolates. This case is notable because TK- HSV have, in the past, lacked neurovirulence and because acyclovir resistance developed during therapy and caused the patient's death.

AB - A case is reported of relapsing fatal meningoencephalitis caused by a neurovirulent thymidine kinase-positive (TK+) type 2 herpes simplex virus (HSV) that developed thymidine kinase deficiency (TK-) during intravenous acyclovir therapy. A patient with AIDS was admitted for acyclovir treatment of a persistent perirectal herpetic ulcer. He subsequently developed meningoencephalitis. A TK+ type 2 HSV was isolated from a brain biopsy specimen. A progressive and fatal relapse occurred, and a TK- type 2 HSV was isolated from his cerebrospinal fluid. Restriction endonuclease analysis of viral DNA from perianal, brain, and cerebrospinal fluid isolates were similar, suggesting that they were the same viral strain. Animal virulence studies indicated significant cutaneous virulence in immunocompromised mice models for the TK- isolates. This case is notable because TK- HSV have, in the past, lacked neurovirulence and because acyclovir resistance developed during therapy and caused the patient's death.

UR - http://www.scopus.com/inward/record.url?scp=0025371895&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025371895&partnerID=8YFLogxK

M3 - Article

C2 - 2156946

AN - SCOPUS:0025371895

VL - 161

SP - 711

EP - 715

JO - The Journal of infectious diseases

JF - The Journal of infectious diseases

SN - 0022-1899

IS - 4

ER -