Treatments for Ocular Herpes
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Genital herpes:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Acyclovir has proved to be an effective treatment for genital herpes. I.V. administration may be required for patients who are hospitalized with severe genital herpes or for those who are immunocompromised and have a potentially life-threatening herpes infection. Oral acyclovir may be prescribed for the patient with a first-time infection or recurrent outbreak. Other agents include famciclovir, valacyclovir, and penciclovir; these drugs suppress symptoms but don’t cure the infection. Daily prophylaxis with acyclovir reduces the frequency of recurrences by at least 50%, but this is only appropriate for a patient with frequent outbreaks and may not decrease transmission rate of the disease.
Foscavir, a powerful antiviral agent, is the treatment of choice for herpes strains that are severe in nature or have become resistant to acyclovir and similar drugs. Administered I.V., foscavir can have several toxic effects, such as reversible impairment of kidney function or induction of sei-zures. As with other antiviral drugs, this drug doesn’t cure herpes.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Herpes simplex:
Treatment
(Professional Guide to Diseases (Eighth Edition))
No cure for herpes exists; however, recurrences tend to be milder and of shorter duration than the primary infection. Symptomatic and supportive therapy is essential. Generalized primary infection usually requires an analgesic-antipyretic to reduce fever and relieve pain. Anesthetic mouthwashes, such as viscous lidocaine, may reduce the pain of gingivostomatitis, enabling the patient to eat and preventing dehydration. (Avoid alcohol-based mouthwashes.) Drying agents, such as calamine lotion, ease the pain of labial or skin lesions. Avoid petroleum-based ointments, which promote viral spread and slow healing.
Refer patients with eye infections to an ophthalmologist. Topical corticosteroids are contraindicated in active infection, but idoxuridine, trifluridine, and vidarabine are effective.
Oral acyclovir may bring relief to patients with genital herpes. Frequent prophylactic use of acyclovir in immunosuppressed transplant patients prevents disseminated disease.Foscarnet can be used to treat HVH that’s resistant to acyclovir. Anti-viral agents similar to acyclovir are valacyclovir and famciclovir. These agents are more active than acyclovir.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Herpes zoster:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Antiviral therapy is the mainstay of treatment. Acyclovir seems to stop the rash’s progression and prevent visceral complications. Capsaicin, transcutaneous electrical nerve stimulation, and low-dose amitriptyline are the current treatments of choice for postherpetic neuralgia. Topical antiviral ointment is helpful if started early in the disease process.
Herpes zoster can resolve spontaneously and may only require symptomatic treatment, the goal of which is to relieve itching and neuralgic pain with calamine lotion or another antipruritic; aspirin, possibly with codeine or another analgesic; and, occasionally, collodion or compound benzoin tincture applied to unbroken lesions.
If bacteria have infected ruptured vesicles, the treatment plan usually includes an appropriate systemic antibiotic.
Trigeminal zoster with corneal involvement calls for instillation of idoxuridine ointment or another antiviral agent. To help a patient cope with the intractable pain of postherpetic neuralgia, the physician may order systemic corticosteroids — such as cortisone or possibly corticotropin — to reduce inflammation (although their use is controversial). He also may prescribe tranquilizers, sedatives, or tricyclic antidepressants with phenothiazines. In some immunocompromised patients — both children and adults — acyclovir I.V. appears to prevent disseminated, life-threatening disease. High doses of interferon (an antiviral glycoprotein) have been used in patients with cancer when the herpetic lesions are limited to the dermatome.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Herpes simplex:
Treatment
(Handbook of Diseases)
Symptomatic and supportive therapy is essential. Generalized primary infection usually requires an analgesic-antipyretic to reduce fever and relieve pain. Anesthetic mouthwashes, such as viscous lidocaine, may reduce the pain of gingivostomatitis, enabling the patient to eat and preventing dehydration. Drying agents, such as calamine lotion, make labial lesions less painful.
Refer patients with eye infections to an ophthalmologist. Topical cortico-steroids are contraindicated in active infection, but idoxuridine, trifluridine, and vidarabine are effective.
A 5% acyclovir ointment may bring relief to patients with genital herpes or to immunosuppressed patients with HVH skin infections. I.V. acyclovir helps treat more severe infections. (See Treating and preventing herpes simplex.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Herpes zoster:
Treatment
(Handbook of Diseases)
No specific treatment exists. The primary goal of supportive treatment is to relieve itching and neuralgic pain with calamine lotion or another antipruritic; aspirin, possibly with codeine or another analgesic; and, occasionally, collodion or compound benzoin tincture applied to unbroken lesions.
If bacteria have infected ruptured vesicles, treatment usually includes an appropriate systemic antibiotic.
Trigeminal zoster with corneal involvement necessitates instillation of idoxuridine ointment or another antiviral agent.
To help a patient cope with the intractable pain of postherpetic neuralgia, administer a systemic corticosteroid, such as cortisone or, possibly, corticotropin, to reduce inflammation as well as tranquilizers, sedatives, or tricyclic antidepressants with phenothiazines.
Acyclovir seems to stop progression of the rash and prevent visceral complications. In immunocompromised patients — both children and adults — acyclovir therapy may be administered I.V. The drug appears to prevent disseminated, life-threatening disease in some patients.
Clinical tip Acyclovir and famciclovir shorten the duration of pain and symptoms in normal adults.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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