title: Fatal primary infection due to human herpesvirus 6 variant A in a renal transplant recipient.
abstract: We describe a fatal primary human herpesvirus 6 (HHV-6) variant A infection in a kidney transplanted adult woman. On day 20 post transplantation (TX), after rejection therapy, the patient presented an acute hemophagocytic syndrome with hepatitis and central nervous system involvement. HHV-6 IgG and IgM antibodies seroconversion was demonstrated. HHV-6 variant A was the sole pathogen detected by nested PCR and/or culture in blood, bone marrow aspiration, liver biopsy, cerebrospinal fluid and bronchoalveolar lavage. The graft was HHV-6 seropositive and the patient was not transfused before day 28 post TX, suggesting that the virus was transmitted by the graft. Despite immunoglobulins, ganciclovir and foscarnet therapy, the HHV-6 infection progressed and led to severe aplasia. The patient developed Aspergillus fumigatus pneumonia and died from fulminant candidemia. This case demonstrated for the first time that HHV-6 variant A primary infection can cause life-threatening disseminated infection in immunosuppressed patients.
authors.affiliation: Infectious Diseases Clinic, Department of Nephrology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: M L
authors.initials: ML
authors.lastname: Delforge
authors.forename: F
authors.initials: F
authors.lastname: Jacobs
authors.forename: M
authors.initials: M
authors.lastname: Wissing
authors.forename: O
authors.initials: O
authors.lastname: Pradier
authors.forename: M
authors.initials: M
authors.lastname: Remmelink
authors.forename: B
authors.initials: B
authors.lastname: Byl
authors.forename: J P
authors.initials: JP
authors.lastname: Thys
authors.forename: C
authors.initials: C
authors.lastname: Liesnard
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D017809:Fatal Outcome; D005260:Female; D014644:Genetic Variation; D006566:Herpesviridae Infections / Q000453:epidemiology / Q000235:genetics*; D015654:Herpesvirus 6, Human / Q000276:immunology; D015616:Histiocytosis, Non-Langerhans-Cell / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D013997:Time Factors
chemical_list: D000914:Antibodies, Viral