Tissue necrosis following extravasation of acyclovir in an adolescent: A case report

Abstract

Objective: Extravasation of intravenously infused vesicant solutions is a common problem in medical practice, which can lead to severe and progressive tissue dysfunction, ranging from persistent tissue oedema and fibrosis to delayed tissue necrosis. Acyclovir is a known vesicant medication administrated in paediatric patients, which appears to irritate venous and soft tissue if extravasated.

Case report: We present the first case involving the extravasation of intravenously infused acyclovir in a female adolescent patient, which caused tissue necrosis and left behind a residual scar lesion. Nursing and medical staff should be aware of the potential dermatological side effects of intravenously infused acyclovir and other medications, even a long time after infusion, and the possible lack of initial local symptoms and signs.

Conclusion: Early recognition of extravasation and prompt management are critical in preventing further morbidity, and optimizing outcomes.

Keywords: Acyclovir; Extravasation; Tissue necrosis.