Death Delusions and Myoclonus: Acyclovir Toxicity

Highlights • AIN can be misdiagnosed as herpes encephalitis. • Hallucinations, myoclonus, and death delusions are more specific presenting symptoms of AIN. • Elevated CSF 9-CMMG levels (metabolite of acyclovir) confirm the diagnosis. • Treatment of AIN includes discontinuation of acyclovir and hemod...

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Bibliographic Details
Published inThe American journal of medicine Vol. 128; no. 7; pp. 692 - 694
Main Authors Gentry, James L., MD, Peterson, Cecily, MD
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.07.2015
Elsevier Sequoia S.A
Subjects
Acute Kidney Injury - chemically induced
Acute Kidney Injury - therapy
Acyclovir - therapeutic use
Acyclovir - toxicity
Aged
Antiviral drugs
Attitude to Death
Clinical outcomes
Delusions - chemically induced
Delusions - physiopathology
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Herpes Zoster - diagnosis
Herpes Zoster - drug therapy
Humans
Internal Medicine
Medical diagnosis
Medical treatment
Myoclonus - chemically induced
Myoclonus - physiopathology
Nervous System Diseases - cerebrospinal fluid
Nervous System Diseases - chemically induced
Nervous System Diseases - therapy
Neuropsychological Tests
Neurotoxicity
Renal Dialysis - methods
Risk Assessment
Viral infections
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Summary:Highlights • AIN can be misdiagnosed as herpes encephalitis. • Hallucinations, myoclonus, and death delusions are more specific presenting symptoms of AIN. • Elevated CSF 9-CMMG levels (metabolite of acyclovir) confirm the diagnosis. • Treatment of AIN includes discontinuation of acyclovir and hemodialysis. • With proper renal dosing, AIN is an easily preventable condition.
ISSN:0002-9343
1555-7162
DOI:10.1016/j.amjmed.2015.03.001