Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Methotrexate

Methotrexate Reactions 1680, p222 - 2 Dec 2017 Herpes simplex type 2 encephalitis: case report A 79-year-old man developed herpes simplex virus type-2 (HSV-2) encephalitis during treatment with methotrexate. The man, who had a history of peripheral spondyloarthritis (HLA-B27-positive), was receiving methotrexate 20 mg/week for two years [route not stated]. He was hospitalised for with a 4-day history of acute confusion, aphasia, fever and temporospatial disorientation. An EEG revealed slow wave activity. His CSF specimen showed protein level of 2.7 g/L, WBC count of 56 cells/mm (20% neutrophils and 80% lymphocytes) and glucose level of 4.2 mmol/L. The man was empirically treated with ceftriaxone, acyclovir and cotrimoxazole [sulfamethoxazole/trimethoprim]. Polymerase chain reaction (PCR) detected HSV-2 DNA in the CSF (HSV-2 load, 5.37 log10 copies/mL). Methotrexate and antibiotics were discontinued and acyclovir was continued. The PCR for Epstein-Barr virus (EBV) DNA was positive in the CSF with a viral load of 2.7 log10 copies/mL. The EBV serology showed a past infection and the possibility of EBV reactivation was considered. Two serum samples were taken at admission and two weeks later were retrospectively analysed with a commercially available HSV type-specific serological assay. Both of the serum samples examination were positive for HSV-2 IgG http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Methotrexate

Reactions Weekly , Volume 1680 (1) – Dec 2, 2017

Methotrexate

Abstract

Reactions 1680, p222 - 2 Dec 2017 Herpes simplex type 2 encephalitis: case report A 79-year-old man developed herpes simplex virus type-2 (HSV-2) encephalitis during treatment with methotrexate. The man, who had a history of peripheral spondyloarthritis (HLA-B27-positive), was receiving methotrexate 20 mg/week for two years [route not stated]. He was hospitalised for with a 4-day history of acute confusion, aphasia, fever and temporospatial disorientation. An EEG revealed slow wave activity....
Loading next page...
 
/lp/springer-journals/methotrexate-FkMJ7WkKoJ

References (1)

Publisher
Springer Journals
Copyright
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
DOI
10.1007/s40278-017-39153-4
Publisher site
See Article on Publisher Site

Abstract

Reactions 1680, p222 - 2 Dec 2017 Herpes simplex type 2 encephalitis: case report A 79-year-old man developed herpes simplex virus type-2 (HSV-2) encephalitis during treatment with methotrexate. The man, who had a history of peripheral spondyloarthritis (HLA-B27-positive), was receiving methotrexate 20 mg/week for two years [route not stated]. He was hospitalised for with a 4-day history of acute confusion, aphasia, fever and temporospatial disorientation. An EEG revealed slow wave activity. His CSF specimen showed protein level of 2.7 g/L, WBC count of 56 cells/mm (20% neutrophils and 80% lymphocytes) and glucose level of 4.2 mmol/L. The man was empirically treated with ceftriaxone, acyclovir and cotrimoxazole [sulfamethoxazole/trimethoprim]. Polymerase chain reaction (PCR) detected HSV-2 DNA in the CSF (HSV-2 load, 5.37 log10 copies/mL). Methotrexate and antibiotics were discontinued and acyclovir was continued. The PCR for Epstein-Barr virus (EBV) DNA was positive in the CSF with a viral load of 2.7 log10 copies/mL. The EBV serology showed a past infection and the possibility of EBV reactivation was considered. Two serum samples were taken at admission and two weeks later were retrospectively analysed with a commercially available HSV type-specific serological assay. Both of the serum samples examination were positive for HSV-2 IgG

Journal

Reactions WeeklySpringer Journals

Published: Dec 2, 2017

There are no references for this article.