Human herpesvirus-6 meningoencephalitis in a recipient of an unrelated allogeneic bone marrow transplantation.
BACKGROUND
Human herpesvirus-6 (HHV-6) has been implicated in bone marrow suppression, interstitial pneumonitis, and fatal meningoencephalitis in bone marrow transplant (BMT) recipients.


METHODS
We describe the case of a woman with acute myeloid leukemia in second remission who developed febrile meningoencephalitis 8 months after a second unrelated BMT.


RESULTS
Computed tomography and magnetic resonance images of the brain were nonspecific. Analysis of cerebrospinal fluid (CSF) revealed lymphocytosis and an increased protein level. Using polymerase chain reaction methods, HHV-6 was the only pathogen detected in CSF, peripheral blood mononuclear cells, and bone marrow. The patient was treated with ganciclovir and foscarnet for 3 months. All clinical manifestations resolved and HHV-6 polymerase chain reaction analysis of CSF became negative 40 days after the beginning of antiviral treatment.


CONCLUSIONS
This observation strongly suggests that HHV-6 should be sought in BMT patients with neurological complications and that HHV-6 meningoencephalitis may respond to ganciclovir and foscarnet therapy.
Rieux
C
C
Service d'Hématologie, Hôpital Henri Mondor, Créteil, France.
Gautheret-Dejean
A
A
Challine-Lehmann
D
D
Kirch
C
C
Agut
H
H
Vernant
J P
JP
D000208:Acute Disease; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006566:Herpesviridae Infections / Q000188:drug therapy; D015654:Herpesvirus 6, Human; D006801:Humans; D007951:Leukemia, Myeloid / Q000601:surgery; D011183:Postoperative Complications; D014184:Transplantation, Homologous
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir