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Herpes simplex-Encephalitis bei Neugeborenen

Behandlung mit 5-Jodo-2′deoxyuridin?

Herpes simplex encephalitis in newborns

Treatment with 5-Iodo-2′-deoxyuridin?

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Abstract

Premature twins both affected with generalized herpes simplex infection including CNS involvement were treated with 5-Iodo-2′-deoxyuridin (IDU). Therapy was started 6 days and 5 days respectively, after appearance of the first symptoms. Nevertheless both babies died, twin A at the age of 24 and twin B at the age of 28 days. Herpes virus was cultured from all organs in twin A. The literature shows a decrease in mortality in children treated with IDU for herpes simplex encephalitis. The percentage of survivors with ultimate severe CNS damage, however, is very high and remains in treated or untreated patients the same. The institution of IDU therapy in neonates with manifest HSV encephalitis is therefore not unequivocally justified.

Zusammenfassung

Frühgeborene Zwillinge mit Encephalitis bei generalisierter Herpes simplex-Virusinfektion (HSV-Infektion) wurden mit 5-Jodo-2′deoxyuridin (IDU) behandelt. Die Behandlung wurde bei Zwilling A am 6., bei Zwilling B am 5. Lebenstag nach Krankheits-beginn eingeleitet. Trotzdem starben beide Zwillinge, Zwilling A im Alter von 24, Zwilling B von 28 Tagen. Bei Zwilling A wurden Viruskulturen auch postmortal angelegt, wobei in allen untersuchten Organen HSV-Virus gefunden wurde.

Der Vergleich zwischen unbehandelten Neugeborenen mit generalisierter HSV-Infektion mit Encephalitis und mit IDU behandelten ergibt zwar eine verminderte Mortalität bei der behandelten Gruppe, jedoch bleibt bei den Überlebenden der prozentuale Anteil von schwer geschädigten Kindern gleich hoch. Man kann sich deshalb fragen, ob die IDU-Therapie wirklich berechtigt ist.

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Literatur

  1. Altshuler, G.: Pathogenesis of congenital herpesvirus infection-Case report including a description of the placenta. Amer. J. Dis. Child. 127, 427–429 (1974)

    Google Scholar 

  2. Amstey, M. S.: Current concepts of herpesvirus infection in the woman. Amer. J. Obstet. Gynec. 117, 717–725 (1973)

    Google Scholar 

  3. Bauer Ch. H., New, M. J., Miller, J. M.: Cerebrospinal fluid protein values of premature infant. J. Pediat. 66, 1017–1022 (1965)

    Google Scholar 

  4. Bellanti, J. A., Catalano, L. W., Chambres, W. R.: Herpes simplex encephalitis: Virologic and serologic study of a patient treated with an interferon inducer. J. Pediat. 78, 136–145 (1971)

    Google Scholar 

  5. Boston Interhospital Virus group and the NIAID-Sponsored Cooperativ Antiviral Clinical Study: Failure of high dose 5-IODO-2-Deoxyuridine in the therapy of herpes simplex virus encephalitis. Evidence of unacceptable toxicity. New Engl. J. Med. 292, 599–603 (1975)

    Google Scholar 

  6. Breeden, C. J., Halt, T. C., Tyler, H. R.: Herpes simplex encephalitis treated with systemic 5-iodo-2-Deoxyuridine. Ann. intern. Med. 65, 1050–1056 (1966)

    Google Scholar 

  7. Calabresi, P.: Current status of clinical investigation with 6-azauridine, 5-IODO-2-Deoxyuridine and related derivatives. Cancer Res. 23, 1260–1264 (1963)

    Google Scholar 

  8. McCallum, F. O., Partridge, J. W.: Fetal maternal relationship in herpes simplex. Arch. Dis. Childh. 43, 265–267 (1968)

    Google Scholar 

  9. Catalano, L. W., Safley, G. H., Museles, M., Jarzynski, D. J.: Disseminated herpes virus infection in a newborn infant. J. Pediat. 79, 393–400 (1970)

    Google Scholar 

  10. Charnock, E. L., Cramblett, H. G.: 5-IODO-2-Deoxyuridine in neonatal herpesvirus hominis encephalitis. J. Pediat. 76, 459–643 (1970)

    Google Scholar 

  11. CH'ien, L. T., Whitley, R. J., Nahmias, A. J., Lewin, E. B., Linnemann, C. C., Frenkel, L. D., Bellanti, J. A., Buchanan, R. A., Altford, Ch. A.: Antiviral chemotherapy and neonatal herpes simplex virus infection: A pilot study experience with adenine arabinoside (ARA-A). Pediatrics 55, 678–685 (1975)

    Google Scholar 

  12. Flanders, R. W., Person, D. A., Orren, J. M., Adams, J. M., Rawls, W. E.: Is herpes simplex infection of the newborn preventable?—The possible role of cesarean section in minimizing risk. Clin. pediat. II, 293–294 (1972)

    Google Scholar 

  13. Flormann, A. L., Gershon, A. A., Blackett, P. D., Nahmias, A. J.: Intrauterine infection with herpes simplex virus. Resultant congenital malformations. J. Amer. med. Ass. 225, 129–132 (1973)

    Google Scholar 

  14. Frentz, J. M., Gohd, R. S., Woody, N. C.: Untreated neonatal herpes simplex 2 meningitis without apparent neurologic damage. J. Pediat. 85, 77–79 (1974)

    Google Scholar 

  15. Gershon, A. A., Fish, I., Brunell, P. A.: Herpes simplex infection of the newborn. Amer. J. Dis. Child. 124, 739–741 (1972)

    Google Scholar 

  16. Golden, B., Bell, W. E., Kee, A.: Disseminated herpes simplex with encephalitis in a neonate-treatment with idoxuridine. J. Amer. med. Ass. 209, 1219–1221 (1969)

    Google Scholar 

  17. Haynes, R. E., Azimi, P. H., Cramblett, H. G.: Fatal herpesvirus hominis (herpes simplex virus) infections in children. J. Amer. med. Ass. 206, 312–319 (1968)

    Google Scholar 

  18. Hudson, A. W., McFarland, C.: Disseminated herpes simplex in a newborn. J. Amer. med. Ass. 208, 859–861 (1969)

    Google Scholar 

  19. Lerner, A. M., Bailey, E. J.: Concentrations of idoxuridine in serum, urine and cerebrospinal fluid of patients with suspected diagnoses of herpes virus hominis encephalitis. J. clin. Invest. 51, 45–49 (1972)

    Google Scholar 

  20. Light, I. J., Linnemann, C. C.: Neonatal herpes simplex infection following delivery by cesarean section. Obstet. and Gynec. 44, 496–499 (1974)

    Google Scholar 

  21. Miller, D. R., Hanshaw, J. B., O'Leary, D. S., Hnilicka, J. V.: Fatal disseminated herpes simplex virus infection and hemorrhage in the neonate. J. Pediat. 76, 409–415 (1970)

    Google Scholar 

  22. Nahmias, A. J., Dowdle, W. R., Josey, W. E., Naib, Z. M., Painter, L. M., Luce, C.: Newborn infection with herpesvirus hominis types 1 and 2. J. Pediat. 75, 1194–1202 (1969)

    Google Scholar 

  23. Nahmias, A. J., Alford, Ch. A., Korones, Sh. B.: Infection of the newborn with herpes-virus hominis. Advanc. Pediat. 17, 185–226 (1970)

    Google Scholar 

  24. Nahmias, A. J., Roizman, B.: Infection with herpes simplex viruses 1 and 2. New Engl. J. Med. II, 667–673, 715–725, 781–789 (1973)

    Google Scholar 

  25. Partridge, J. W., Millis, R. R.: Systemic herpes simplex infection in a newborn treated with intravenous idoxuridine. Arch. Dis. Childh. 45, 377–381 (1968)

    Google Scholar 

  26. Pettay, O., Leinikki, P., Donner, M., Lapinleimu, K.: Herpes simplex virus infection in the newborn. Arch. Dis. Childh. 47, 97–103 (1972)

    Google Scholar 

  27. Torphy, D. E., Ray, C. G., McAlister, R., Du, J. N. H.: Herpes simplex virus infection in infants: a spectrum of disease. J. Pediat. 76, 405–408 (1970)

    Google Scholar 

  28. Tuffli, G. A., Nahmias, A. J.: Neonatal nerpetic infection. Amer. J. Dis. Child. 118, 909–914 (1969)

    Google Scholar 

  29. Witzleben, C. L., Driscoll, Sh. G.: Possible transplacental transmission of herpes simplex infection. Pediatrics 36, 192–199 (1965)

    Google Scholar 

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Authors and Affiliations

  1. Neonatologische Abteilungen der Universitäts-Kinderklinik und Universitäts-Frauenklinik, Zurich, Schweiz

    R. Nüssli, H. P. Kind & G. Duc (Leiter)

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  1. R. Nüssli
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  2. H. P. Kind
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  3. G. Duc
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Nüssli, R., Kind, H.P. & Duc, G. Herpes simplex-Encephalitis bei Neugeborenen. Eur J Pediatr 122, 131–137 (1976). https://doi.org/10.1007/BF00466271

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  • DOI: https://doi.org/10.1007/BF00466271

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