BACKGROUND: Diagnosis and management of Acute Retinal Necrosis (ARN) in children that does not respond to systemic acyclovir treatment can be challenging. We report two cases of ARN secondary to herpes simplex virus (HSV) type 2 that was resistant to acyclovir but was treated successfully with intravenous foscarnet. CASE REPORT: Two children diagnosed with ARN failed to show clinical response to systemic acyclovir treatment. Both cases had histories of previous HSV infections and vitreous taps positive for HSV-2. Both were converted to systemic foscarnet treatment with successful control of the retinitis and satisfactory visual outcomes. CONCLUSIONS: Systemic foscarnet can be effective in the management of pediatric acute retinal necrosis caused by HSV-2 when there is an atypical response to conventional acyclovir treatment.
BACKGROUND: Diagnosis and management of Acute Retinal Necrosis (ARN) in children that does not respond to systemic acyclovir treatment can be challenging. We report two cases of ARN secondary to herpes simplex virus (HSV) type 2 that was resistant to acyclovir but was treated successfully with intravenous foscarnet. CASE REPORT: Two children diagnosed with ARN failed to show clinical response to systemic acyclovir treatment. Both cases had histories of previous HSV infections and vitreous taps positive for HSV-2. Both were converted to systemic foscarnet treatment with successful control of the retinitis and satisfactory visual outcomes. CONCLUSIONS: Systemic foscarnet can be effective in the management of pediatric acute retinal necrosis caused by HSV-2 when there is an atypical response to conventional acyclovir treatment.
Authors: Roberto Gallego-Pinazo; Miguel Harto; Jose J Garcia-Medina; Inmaculada Serra; Enrique España; Maria D Pinazo-Duran Journal: Clin Ophthalmol Date: 2008-06