Ganciclovir

Ganciclovir Reactions 1680, p149 - 2 Dec 2017 Right bundle branch block: case report A 12-year-old boy developed right bundle branch block (RBBB) during treatment with ganciclovir [Cymevene; dosage and duration of treatment to reaction onset not stated]. The boy was hospitalised due to chest pain and shortness of breath. He initially developed runny nose, fever and cough, which later progressed to chest pain and shortness of breath over 10 days. Upon hospitalisation, he developed tachypnoea, tachycardia and fever. Subsequently, he was started on empirical treatment with various IV unspecified antibiotics. However, his condition continued to deteriorate, and required ventilatory support. Thereafter, his antibiotic therapy was upgraded, but he developed severe acute respiratory distress syndrome and septic shock. After that, unspecified antifungals were also added to his treatment regimen, and inotropic support was provided. Despite receiving aggressive treatment, his condition continued to worsen and he developed hypotension, acute kidney injury and multi organ failure. Later, lung biopsy was performed, which led to the diagnosis of CMV pneumonitis. Hence, his treatment was initiated with IV ganciclovir. The treatment resulted in a significant improvement, and his fever subsided. The inotropic support and ventilation were withdrawn. However, during the treatment he developed RBBB. The boy’s ganciclovir dose was reduced, and RBBB resolved. He recovered completely, and was discharged after 21 days of hospitalisation. Author comment: "During Ganciclovir treatment course, the patient developed right bundle branch block (RBBB) probably as a rare side effect of Ganciclovir therapy. . .Rather than using a sole clinical judgment, score of 5 on Naranjo causality scale,indicates a probable relationship between Ganciclovir administration and RBBB." Al-Eyadhy AA, et al. Cytomegalovirus associated severe pneumonia, multi-organ failure and Ganciclovir associated arrhythmia in immunocompetent child. Journal of Infection and Chemotherapy 23: 844-847, No. 12, Dec 2017. Available from: URL: http://doi.org/10.1016/j.jiac.2017.08.003 - Saudi Arabia 803284473 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Ganciclovir

Reactions Weekly , Volume 1680 (1) – Dec 2, 2017
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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
D.O.I.
10.1007/s40278-017-39080-3
Publisher site
See Article on Publisher Site

Abstract

Reactions 1680, p149 - 2 Dec 2017 Right bundle branch block: case report A 12-year-old boy developed right bundle branch block (RBBB) during treatment with ganciclovir [Cymevene; dosage and duration of treatment to reaction onset not stated]. The boy was hospitalised due to chest pain and shortness of breath. He initially developed runny nose, fever and cough, which later progressed to chest pain and shortness of breath over 10 days. Upon hospitalisation, he developed tachypnoea, tachycardia and fever. Subsequently, he was started on empirical treatment with various IV unspecified antibiotics. However, his condition continued to deteriorate, and required ventilatory support. Thereafter, his antibiotic therapy was upgraded, but he developed severe acute respiratory distress syndrome and septic shock. After that, unspecified antifungals were also added to his treatment regimen, and inotropic support was provided. Despite receiving aggressive treatment, his condition continued to worsen and he developed hypotension, acute kidney injury and multi organ failure. Later, lung biopsy was performed, which led to the diagnosis of CMV pneumonitis. Hence, his treatment was initiated with IV ganciclovir. The treatment resulted in a significant improvement, and his fever subsided. The inotropic support and ventilation were withdrawn. However, during the treatment he developed RBBB. The boy’s ganciclovir dose was reduced, and RBBB resolved. He recovered completely, and was discharged after 21 days of hospitalisation. Author comment: "During Ganciclovir treatment course, the patient developed right bundle branch block (RBBB) probably as a rare side effect of Ganciclovir therapy. . .Rather than using a sole clinical judgment, score of 5 on Naranjo causality scale,indicates a probable relationship between Ganciclovir administration and RBBB." Al-Eyadhy AA, et al. Cytomegalovirus associated severe pneumonia, multi-organ failure and Ganciclovir associated arrhythmia in immunocompetent child. Journal of Infection and Chemotherapy 23: 844-847, No. 12, Dec 2017. Available from: URL: http://doi.org/10.1016/j.jiac.2017.08.003 - Saudi Arabia 803284473 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680

Journal

Reactions WeeklySpringer Journals

Published: Dec 2, 2017

References

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