SUCCESSFUL FOSCARNET THERAPY FOR MUCOCUTANEOUS INFECTION WITH HERPES-SIMPLEX VIRUS IN A RECIPIENT AFTER UNRELATED BONE-MARROW TRANSPLANTATION

A 36-year-old Japanese man who received an unrelated bone marrow trans plant (BMT) developed severe mucocutaneous infection with herpes simpl ex virus (HSV) type 1 during oral acyclovir prophylaxis, The lesions p rogressed despite treatment with intravenous acyclovir and vidarabine, The HSV isolates were sensitive to acyclovir, vidarabine and foscarne t in vitro, but peripheral CD3- or CD19-positive cells were barely det ectable even 4 months after transplant. A 12-day course of treatment w ith foscarnet led to a rapid improvement, Foscarnet therapy should be considered for all severe HSV infections following BMT, regardless of whether or not the HSV isolates are sensitive to acyclovir.