Cytomegalovirus ventriculoencephalitis in a bone marrow transplant recipient receiving antiviral maintenance: clinical and molecular evidence of drug resistance.
We describe a case of CMV ventriculoencephalitis in a severely immunocompromised bone marrow transplant recipient who was receiving combination therapy with ganciclovir and foscarnet for treatment of viremia and retinitis. Analysis of sequential viral isolates recovered from the patient's cerebrospinal fluid suggested that disease developed because of the presence of viral resistance and, possibly, low tissue penetration of antiviral agents.
Seo
S K
SK
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Regan
A
A
Cihlar
T
T
Lin
D C
DC
Boulad
F
F
George
D
D
Prasad
V K
VK
Kiehn
T E
TE
Polsky
B
B
D000998:Antiviral Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002552:Cerebral Ventricles / Q000821:virology; D002648:Child; D000077404:Cidofovir; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology*; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004338:Drug Combinations; D024882:Drug Resistance, Viral / Q000235:genetics; D018792:Encephalitis, Viral / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology*; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use*; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D016867:Immunocompromised Host; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000627:therapeutic use*
D000998:Antiviral Agents; D004338:Drug Combinations; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D017245:Foscarnet; D003596:Cytosine; D000077404:Cidofovir; D015774:Ganciclovir