A 49-year-old homeless man comes to the emergency department because of fatigue,abdominal pain, and worsening diarrhea. He was diagnosed with HIV-infection 5 years ago but has never had any symptoms. He has always refused to take antiretroviral medication. on physical examination, there is a tender abdomen. Laboratory results show a CD4 cell count of 38/mm³, leukopenia, and thrombocytopenia. A CT scan of the abdomen reveals colitis. Colonoscopy reveals areas of erosions and ulcerations; pathology demonstrates cells with viral intranuclear and intracytoplasmic inclusions. Antiviral therapy is initiated to treat the colitis with an intravenous agent that does not require intracellular activation and is known to bind in vitro with viral-encoded enzymes such as DNA polymerase, RNA polymerase, and reverse transcriptase. Which of the following agents did this patient most likely receive?

Question

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Eductional Objective: Of all the antiviral agents that bind and inhibit DNA polymerase in herpesvirus and reverse transcriptase in HIV, the pyrophosphate analog foscarnet is one of few that do not require intracellular activation by viral or cellular kinases.

A 49-Year-Old Homeless Man Comes to the Emergency Department Because