title: Intact survival of refractory CMV limbic encephalitis in a patient with severe aplastic anemia after unrelated bone marrow transplantation.
abstract: We described a patient of refractory cytomegalovirus (CMV) limbic encephalitis who received matched unrelated bone marrow transplantation. Pyrosequencing study on serial cerebrospinal fluid samples revealed the emergence of resistant strains associated with exposure of antiviral agents. Combinations of antiviral agents had a role in partial suppression of CMV viral load but the clearance of virus mainly relied on the recovery of host's immunity and resulted in intact survival of host. Donor's CMV-seronegative status may contribute to the delay in controlling this serious infection. Prompt identification of drug-resistant mutant helps in selection of antiviral agents.
authors.affiliation: Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong.
authors.forename: Dorothy Yuen Shan
authors.initials: DY
authors.lastname: Tam
authors.forename: Frankie Wai Tsoi
authors.initials: FW
authors.lastname: Cheng
authors.forename: Paul Kay Sheung
authors.initials: PK
authors.lastname: Chan
authors.forename: Wing Kwan
authors.initials: WK
authors.lastname: Leung
authors.forename: Vincent
authors.initials: V
authors.lastname: Lee
authors.forename: Ming Kong
authors.initials: MK
authors.lastname: Shing
authors.forename: Jo Lai Ken
authors.initials: JL
authors.lastname: Cheung
authors.forename: Chi Kong
authors.initials: CK
authors.lastname: Li
mesh_terms: D000741:Anemia, Aplastic / Q000150:complications / Q000628:therapy*; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003587:Cytomegalovirus / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D024882:Drug Resistance, Viral; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D020363:Limbic Encephalitis / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality*; D011379:Prognosis; D012173:Retinitis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D015996:Survival Rate
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir