Herpesvirus-6 encephalitis complicated by Wernicke-Korsakoff syndrome in a pediatric recipient of unrelated cord blood transplantation.
A 10-year-old girl with M2 acute myeloid leukemia underwent an unrelated cord blood transplantation in refractory first relapse. On day +13, after 48 hours with fever, she showed a measles-like rash, and on day +15, she began experiencing neurologic symptoms (headache, tremors, weakness, nystagmus, mild confusion, speaking, taste, and behavior disturbances, and focal seizures). She also had amnesia for recent events with disability to learn, mimicking Wernicke-Korsakoff syndrome. Computed tomography of the brain and cerebrospinal fluid (CSF) and electroencephalogram were nonspecific. We found human herpesvirus 6 (HHV-6) DNA in CSF and cytomegalovirus in bronchoalveolar lavage using polymerase chain reaction techniques. Treatment with ganciclovir and foscarnet was effective, with total resolution of symptoms.
Carvajal
E
E
Unidad de Oncología Pediátrica, Hospital Infantil La Fe, Valencia, Spain.
Verdeguer
A
A
Fernández
J M
JM
Cañete
A
A
Castel
V
V
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D018792:Encephalitis, Viral / Q000188:drug therapy / Q000209:etiology*; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D005312:Fetal Blood / Q000166:cytology; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D016867:Immunocompromised Host; D020915:Korsakoff Syndrome / Q000209:etiology*; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D012008:Recurrence; D019349:Roseolovirus Infections / Q000188:drug therapy / Q000209:etiology*; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D014775:Virus Activation
D000998:Antiviral Agents; D003561:Cytarabine; D017245:Foscarnet; D005047:Etoposide; D015774:Ganciclovir; D003630:Daunorubicin