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Combined therapy with ganciclovir and foscarnet for CMV polyradiculomyelitis.




 

Int Conf AIDS. 1994 Aug 7-12;10(2):127 (abstract no. PB0520). Unique

OBJECTIVE: To evaluate the efficacy of a dual anti-cytomegalovirus (CMV) therapy in 3 cases of CMV polyradiculomyelitis. PATIENTS AND METHODS: Three men with AIDS, presented with progressive paraparesis in their lower limbs, together with a cauda equine syndrome. Two were previously treated for CMV retinitis: Pt 2 has been treated with Foscarnet for one year, and Pt 3 with Ganciclovir for 6 months. Cerebrospinal fluid (CSF) contained polymorphonuclear leukocytes, hyperproteinorachia and normal or low glycorrhachia. CMV was detected in blood and CSF using culture and PCR, confirming the diagnosis. The 3 patients were treated with combined therapy with full dose Foscarnet and Ganciclovir, instituted 2 weeks after the initial symptoms. RESULTS: 1/Neurological status dramatically improved (i.e. able to walk) after 3 weeks of treatment. 2/CSF was cleared in blood and CSF in all cases after 3 weeks, as shown in the Table:. TABULAR DATA, SEE ABSTRACT VOLUME. 3/Renal insufficiency was observed in one patient during the fourth week, leading to reduce the dose of Foscarnet; neutropenia in another, leading to institute granulocyte colony stimulating factor. DISCUSSION AND CONCLUSIONS: After early recognition of CMV polyradiculomyelitis, a combination of antiviral regimen appears as an attractive therapy. It is not ascertained that improvement is due to the early institution of the treatment and/or to the dual anti-CMV regimen.

AIDS-Related Opportunistic Infections/COMPLICATIONS/*DRUG THERAPY/ MICROBIOLOGY Case Report Cerebrospinal Fluid/MICROBIOLOGY Cytomegalovirus/ISOLATION & PURIF Cytomegalovirus Infections/COMPLICATIONS/*DRUG THERAPY/ MICROBIOLOGY Drug Therapy, Combination Foscarnet/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Ganciclovir/*ADMINISTRATION & DOSAGE Human Kidney Failure/CHEMICALLY INDUCED Male Myelitis/COMPLICATIONS/*DRUG THERAPY/MICROBIOLOGY Neutropenia/CHEMICALLY INDUCED Polyradiculitis/COMPLICATIONS/*DRUG THERAPY/MICROBIOLOGY Viremia/COMPLICATIONS/DRUG THERAPY ABSTRACT



 




Information in this article was accurate in December 30, 1994. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.