# Extravasation of Intravenous Acyclovir in a Patient With Human Herpesvirus 7 Encephalitis: A Case Report

## TL;DR

A patient with HHV-7 encephalitis developed skin lesions from acyclovir extravasation, emphasizing the need for prompt recognition and treatment.

## Contribution

This case report presents a rare instance of acyclovir extravasation in HHV-7 encephalitis, highlighting management strategies.

## Key findings

- Immediate vesicular skin lesions occurred at the acyclovir infusion site in a patient with HHV-7 encephalitis.
- Extravasation was confirmed by rapid improvement after drug withdrawal and cold compression.
- Early detection and management, including saline infiltration and hyaluronidase, minimized injury.

## Abstract

Acyclovir is a widely used antiviral agent, but intravenous administration can cause cutaneous adverse reactions, particularly extravasation. We report a rare case of acyclovir extravasation in a 20-year-old female patient with human herpesvirus 7 (HHV-7) encephalitis, who developed immediate vesicular skin lesions at the infusion site. The rapid improvement after drug withdrawal and cold compression favored extravasation over herpes infection progression or drug eruption. Acyclovir’s high osmolality and alkalinity contribute to tissue damage. While no standard protocol exists, early detection, infusion discontinuation, aspiration, saline infiltration, cold compression, and hyaluronidase can help minimize injury. This case highlights the importance of prompt recognition and management to prevent complications.