Ganciclovir-resistant cytomegalovirus encephalitis in a bone marrow transplant recipient.
A 20-year-old patient, who received a bone marrow transplant in order to treat metachromatic leukodystrophy (MLD), succumbed to cytomegalovirus (CMV) encephalitis. After CMV viremia developed, the patient received ganciclovir, but he was switched to foscarnet when ganciclovir resistance was suspected. Foscarnet was discontinued because of concern about its potential central nervous system toxicity. Autopsy samples of brain and cerebrospinal fluid contained CMV DNA with a UL97 mutation (M460V) known to confer ganciclovir resistance. No foscarnet resistance mutations were found.
Julin
J E
JE
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
van Burik
J H
JH
Krivit
W
W
Webb
C
C
Holman
C J
CJ
Clark
H B
HB
Balfour
H H
HH
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D024882:Drug Resistance, Viral; D018792:Encephalitis, Viral / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D007966:Leukodystrophy, Metachromatic / Q000628:therapy; D008297:Male
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir