Summary
An AIDS patient with cytomegalovirus (CMV) retinitis was treated with ganciclovir (10 mg/kg) for four days followed by 5 mg/kg for 69 days. Clinically, CMV retinitis improved during therapy. Two weeks after induction of therapy, the patient became increasingly disorientated, and died 78 days after admission. Microscopically, a necrotizing encephalitis with characteristic cytomegalic cells with intranuclear inclusion bodies was observed. We conclude that ganciclovir therapy did not prevent development or progression of CMV encephalitis in the doses used.
Zusammenfassung
Ein AIDS-Patient mit Cytomegalievirus (CMV) Retinitis wurde mit Ganciclovir (10 mg/kg) über vier Tage, dann mit 5 mg/kg über 69 Tage behandelt. Klinisch verbesserte sich die CMV-Retinitis unter dieser Terapie. Zwei Wochen nach Therapiebeginn wurde der Patient zunehmend disorientiert und verstarb am Tag 78 nach Aufnahme. Mikroskopisch ließ sich eine nekrotisierende Enzephalitis mit charakteristischen Riesenzellen mit intranukleären Einschlußkörpern nachweisen. Die Therapie mit Ganciclovir konnte offensichtlich in dieser Dosierung die Entwicklung oder das Fortschreiten der CMV-Enzephalitis nicht verhindern.
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Schwarz, T.F., Jäger, G., Loeschke, K. et al. CMV encephalitis during ganciclovir therapy of CMV retinitis. Infection 18, 289–290 (1990). https://doi.org/10.1007/BF01647008
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DOI: https://doi.org/10.1007/BF01647008