Differential diagnosis of central nervous system involvement in a patient treated with acyclovir

Acyclovir-induced neuropsychiatric symptoms (AINSs) may resemble several diseases of the central nervous system. Laboratory testing of acyclovir may be critical in supporting the diagnosis of AINSs when there is doubt. We present a case of suspected herpes encephalitis in which the diagnosis of AINS...

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Bibliographic Details
Published inTherapeutic drug monitoring Vol. 35; no. 4; p. 417
Main Authors von Euler, Mia, Axelsson, Gudmundur, Helldén, Anders
Format Journal Article
LanguageEnglish
Published United States 01.08.2013
Subjects
Acyclovir - adverse effects
Acyclovir - blood
Acyclovir - therapeutic use
Antiviral Agents - adverse effects
Antiviral Agents - blood
Antiviral Agents - therapeutic use
Central Nervous System - drug effects
Diagnosis, Differential
Drug Monitoring
Encephalitis, Herpes Simplex - drug therapy
Female
Humans
Mental Disorders - blood
Mental Disorders - chemically induced
Mental Disorders - diagnosis
Middle Aged
Neurotoxicity Syndromes - blood
Neurotoxicity Syndromes - diagnosis
Neurotoxicity Syndromes - etiology
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Summary:Acyclovir-induced neuropsychiatric symptoms (AINSs) may resemble several diseases of the central nervous system. Laboratory testing of acyclovir may be critical in supporting the diagnosis of AINSs when there is doubt. We present a case of suspected herpes encephalitis in which the diagnosis of AINSs was supported by therapeutic drug monitoring of plasma and cerebrospinal fluid concentrations of acyclovir and its main metabolite 9-carboxymethoxymethylguanine.
ISSN:1536-3694
DOI:10.1097/FTD.0b013e31828faa35