Tissue necrosis following extravasation of acyclovir in an adolescent: A case report

Acta Med Acad. 2017 May;46(1):55-58. doi: 10.5644/ama2006-124.187.

Abstract

Objective: Extravasation of intravenously infused vesicant solutions is a common problem in medical practice, which can lead to severe and progressive tissue dysfunction, ranging from persistent tissue oedema and fibrosis to delayed tissue necrosis. Acyclovir is a known vesicant medication administrated in paediatric patients, which appears to irritate venous and soft tissue if extravasated.

Case report: We present the first case involving the extravasation of intravenously infused acyclovir in a female adolescent patient, which caused tissue necrosis and left behind a residual scar lesion. Nursing and medical staff should be aware of the potential dermatological side effects of intravenously infused acyclovir and other medications, even a long time after infusion, and the possible lack of initial local symptoms and signs.

Conclusion: Early recognition of extravasation and prompt management are critical in preventing further morbidity, and optimizing outcomes.

Keywords: Acyclovir; Extravasation; Tissue necrosis.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / adverse effects*
  • Adolescent
  • Antiviral Agents / adverse effects*
  • Encephalitis, Herpes Simplex / drug therapy
  • Extravasation of Diagnostic and Therapeutic Materials / etiology*
  • Extravasation of Diagnostic and Therapeutic Materials / pathology*
  • Female
  • Humans
  • Necrosis

Substances

  • Antiviral Agents
  • Acyclovir