title: Ganciclovir-resistant human herpesvirus-6 encephalitis in a liver transplant patient: a case report.
abstract: Human herpesvirus-6 (HHV-6) was initially isolated in 1986 from patients with lymphoproliferative disorders (Ablashi et al. 1987). Since that time, two genetically distinct variants were sequenced, HHV-6A and HHV-6B (Ablashi and Balachandran 1991). Both variants have been linked with neurologic disease (Crawford et al. 2007). HHV-6 encephalitis has been well described in literature, typically presenting with confusion, coma, seizure, and headache. The majority of HHV-6 encephalitis has been limited to post-transplant recipients (Singh and Paterson 2000). Encephalitis due to HHV-6 infection has been reported in two liver transplant recipients (Massih and Razonable 2009 and Montejo et al. 2002). Although there has been in vitro studies regarding the potential resistance patterns for HHV-6 virus, there has been only one clinic case report supporting these findings (Isegawa et al. 2009). We describe the first case of ganciclovir-resistant HHV-6 encephalitis in a post-liver transplant patient.
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. baldwink@upmc.edu
authors.forename: Kelly
authors.initials: K
authors.lastname: Baldwin
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D004279:DNA, Viral / Q000032:analysis; D024882:Drug Resistance, Viral; D018792:Encephalitis, Viral / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use*; D015774:Ganciclovir / Q000008:administration & dosage / Q000009:adverse effects; D006566:Herpesviridae Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000187:drug effects / Q000502:physiology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D016133:Polymerase Chain Reaction
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D017245:Foscarnet; D015774:Ganciclovir