Fatal herpesvirus-6 encephalitis in a recipient of a T-cell-depleted peripheral blood stem cell transplant from a 3-loci mismatched related donor.
Human herpesvirus-6 (HHV-6), like all the other herpes viruses, remains latent in host cells after primary infection but can be reactivated in immunocompromised patients causing fever, skin rash, bone marrow (BM) suppression, pneumonitis, sinusitis and meningoencephalitis. We describe the case of a man with chronic myelogenous leukemia who developed encephalitis associated with acute graft-versus-host disease two months after a T-cell-depleted mismatched peripheral blood stem cell transplant. Magnetic resonance images of the brain revealed multiple bilateral foci of signal abnormality. HHV-6 was the only pathogen detected in cerebrospinal fluid by PCR. Treatment with both ganciclovir and foscarnet was unsuccessful and the patient gradually deteriorated and died. Other cases of HHV-6 encephalitis after bone marrow transplantation are reviewed.
Tiacci
E
E
Department of Clinical and Experimental Medicine, Hematology and Immunology Section, University of Perugia, Perugia, Italy.
Luppi
M
M
Barozzi
P
P
Gurdo
G
G
Tabilio
A
A
Ballanti
S
S
Torelli
G
G
Aversa
F
F
D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000517:prevention & control; D004279:DNA, Viral; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D017245:Foscarnet / Q000008:administration & dosage; D015774:Ganciclovir / Q000008:administration & dosage; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006566:Herpesviridae Infections; D015654:Herpesvirus 6, Human; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D014019:Tissue Donors; D019172:Transplantation Conditioning; D014775:Virus Activation / Q000187:drug effects
D004279:DNA, Viral; D007166:Immunosuppressive Agents; D017245:Foscarnet; D015774:Ganciclovir