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

81 Scopus citations

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
DOIs
StatePublished - Apr 1990

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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