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Antimicrob Agents Chemother. 1973 March; 3(3): 412–417. | PMCID: PMC444424 |
Cytosine Arabinoside Therapy for Herpes Simplex Encephalitis—Clinical Experience with Six Patients Anthony W. Chow, Allan Ronald, Milan Fiala, William Hryniuk, Marvin L. Weil, Joseph St. Geme, Jr., and Lucien B. Guze Departments of Medicine and Pediatrics, Harbor General Hospital, Torrance, California 90509 Research and Medical Service, Wadsworth Hospital, Veterans Administration Center, Los Angeles, California 90073 Department of Medicine, UCLA School of Medicine, Los Angeles, California 90024 University of Manitoba School of Medicine, Winnipeg, Manitoba, Canada Abstract Two neonates and four adults with herpes simplex virus (HSV) encephalitis were treated with cytosine arabinoside (Ara-C). A low dose of 40 to 160 mg per m2 per day was given for 4 to 6 days by continuous intravenous infusion and, except in two cases, by intrathecal administration. In one patient, idoxuridine (IUdR) at the dose of 1 g every 4 h was also administered after 4 days of Ara-C therapy. Both neonates and two of four adults survived. Their clinical improvement was closely related in time to the onset of therapy with Ara-C (cases 1, 2, 3) and with IUdR (case 4). In one adult who died on the 27th day of illness of a massive pulmonary embolus, postmortem examination of the brain did not disclose viral inclusions, and viral culture was negative. In the other patient who died, however, brain culture postmortem was still positive for HSV despite 4 days of Ara-C therapy. Ara-C, in addition to IUdR, may be effective in HSV encephalitis treatment, but double-blind, controlled studies appear to be necessary with these agents. Full text Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (824K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References. These references are in PubMed. This may not be the complete list of references from this article. - Allen LB, Sidwell RW. Target-organ treatment of neurotropic virus diseases: efficacy as a chemotherapy tool and comparison of activity of adenine arabinoside, cytosine arabinoside, idoxuridine, and trifluorothymidine. Antimicrob Agents Chemother. 1972 Sep;2(3):229–233. [PubMed]
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