A concerned mother brings her 7-day-old son to his pediatrician after he develops a rash. Examination reveals a cluster of erythematous vesicles localized to the child's mouth. The child's vital signs are all within normal limits, and aside from the rash and mild irritability he appears healthy. A sample of tissue is taken from the base of a ruptured vesicle and subjected to the Tzanck test . The child is treated with the most commonly prescribed agent for this condition. Which of the following is a serious adverse effect associated with this drug?
High-Yield Explanation
This child's clinical presentation is suspicious for congenital HSV infection, a diagnosis confirmed by the giant cells with multiple nuclei visualized on the positive Tzanck test Clinical presentation is more suggestive of herpetic lesions as compared to varicella. Fuhermore, the treatment would be the same for both-acyclovir, Acyclovir- crystallizes within the nephron during the process of renal excretion--> renal toxicity Maintaining adequate hydration and a high GFR are helpful in avoiding this adverse event.