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espanolEl tratamiento actual de la neuritis herpetica, basado en la evidencia, comprende la administracion precoz de antivirales y analgesicos que segun su intensidad pueden ser opioides potentes. No es comun realizar en forma rutinaria la monitorizacion de la funcion renal a pesar de que existen reportes sobre insuficiencia renal secundaria al uso de antivirales. Presentamos un caso de nefrotoxicidad por aciclovir, en donde la manifestacion clinica principal fue la alteracion del estado de consciencia que fue interpretado como toxicidad por opioides. Se trata de una paciente femenina de 49 anos con cuadro de neuritis herpetica en tratamiento analgesico con morfina y codeina, quien desarrollo deterioro agudo del estado de consciencia e insuficiencia renal aguda, requiriendo hemodialisis. Consideramos relevante este caso, con la intencion de resaltar la importancia de la monitorizacion de la funcion renal en los pacientes que reciben terapia con estos medicamentos. EnglishBased on the evidence, the current management of herpes zoster and its sequela post-herpetic neuralgia (PHN) relies upon the early onset of antiviral agents and analgesics, and depending on the severity of the pain those can be strong opioids. It is uncommon to monitor the renal function in patients with this treatment, even though there are reports of nephrotoxicity secondary to the antiviral use. We presented a case of a 49-year-old woman who was admitted for herpes zoster treatment, and developed renal insufficiency following a treatment with acyclovir. The main clinical manifestation was a change in the neurologic status, which was first interpreted as opioid toxicity. The patient was treated with hemodialysis obtaining full recovery. We consider this report relevant as it stresses the importance of monitoring the renal function in patients receiving this type of medication.

Nefropatía por aciclovir en un paciente con sospecha de toxicidad por opioides: caso clínico