We encountered a serious case with HSV positive encephalitis. After three weeks treatment with Acyclovir, we did again a lumbar punction. The PCR turned out to be still positive. Is there anyone with experience of doing a LP after three weeks of treatment?
We are desperately seeking for information to be able to put these results in the right perspective.
Thanks
I don't know after three weeks but at 2 weeks, a persistant positive PCR is a sign of acyclovir-resistant herpes simplex virus. Treatment seems to be foscarnet.
"Patients with HSV encephalitis will typically have a negative CSF HSV PCR after 14 days of acyclovir treatment, and a persisting positive PCR should prompt consideration of additional or revised antiviral therapy."
https://www.ncbi.nlm.nih.gov/pubmed/21488834
Article Update on herpes simplex encephalitis
Article [Update on Herpes Simplex Encephalitis]
a recent description of Acyclovir resistance in herpes simplex virus type I encephalitis and way to analyzes ACV-resistance
https://www.ncbi.nlm.nih.gov/pubmed/24671682
https://www.ncbi.nlm.nih.gov/pubmed/24075863
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