Molecular evidence of persistent echovirus 13 meningoencephalitis in a patient with relapsed lymphoma after an outbreak of meningitis in 2000.
Enteroviral meningoencephalitis was diagnosed in a patient with an immunodeficiency syndrome acquired after treatment with rituximab for a relapsed primary B-cell lymphoma. A second meningoencephalitic episode was diagnosed 6 months later and was successfully treated with a combination of immunoglobulins and pleconaril. The infection was persistent since the enterovirus genome was detected in five sequential specimens of cerebrospinal fluid collected over 9 months. An echovirus 13 isolate was isolated in the first three samples. The viral sequence encoding the VP1 capsid protein of the three isolates was determined and was compared with that of four control viruses. The virus isolates recovered from the patient shared >99% nucleotide sequence similarity with one another. In a phylogenetic tree, they were directly related to a control virus obtained from a patient hospitalized in 2000 during an outbreak of enterovirus meningitis. The epidemiological origin of a chronic echovirus infection in a patient with immune deficiency suggests that the echovirus had been continuously circulating in the general population after the outbreak that had revealed its emergence.
Archimbaud
Christine
C
Laboratoire de Virologie, Faculté de Médecine, 63000 Clermont-Ferrand 1, France. christine.ARCHIMBAUD@u-clermont1.fr
Bailly
Jean-Luc
JL
Chambon
Martine
M
Tournilhac
Olivier
O
Travade
Philippe
P
Peigue-Lafeuille
Hélène
H
D000595:Amino Acid Sequence; D036022:Capsid Proteins / Q000235:genetics; D002908:Chronic Disease; D004196:Disease Outbreaks; D029822:Enterovirus B, Human / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000821:virology; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications; D016393:Lymphoma, B-Cell / Q000150:complications*; D008297:Male; D008587:Meningitis, Viral / Q000453:epidemiology* / Q000821:virology; D008590:Meningoencephalitis / Q000821:virology*; D008875:Middle Aged; D008969:Molecular Sequence Data; D012008:Recurrence; D017422:Sequence Analysis, DNA; D013997:Time Factors
D036022:Capsid Proteins