title: Fatal BK virus pneumonia following stem cell transplantation.
abstract: We report the case of a 39-year-old male patient who died of severe BK virus (BKV) pneumonia 168 days after hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia. After suffering from BKV-associated late-onset hemorrhagic cystitis (HC) with long-term sustained BKV viremia, he died of rapidly progressive pneumonia. On autopsy, numerous viral intranuclear inclusions were seen in his lungs and bladder. An immunohistochemical examination of his lungs was positive for simian virus 40. Based on these pathological results and the high sustained BKV viral load in his blood, we reached a diagnosis of BKV pneumonia. Viral infection can occasionally become life threatening among HSCT recipients. It is widely known that BKV can cause late-onset HC, but BKV-associated pneumonia is rare. Because of its rapid progression and poor prognosis, it is difficult to make an antemortem diagnosis of BKV pneumonia. A treatment strategy for BKV pneumonia also needs to be formulated. Similar to other viral pathogens, BKV can cause pneumonia and the clinician should therefore be aware of it in immunocompromised patients.
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Akazawa
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: T
authors.initials: T
authors.lastname: Yamane
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Aimoto
authors.forename: H
authors.initials: H
authors.lastname: Koh
authors.forename: T
authors.initials: T
authors.lastname: Nakane
authors.forename: K-R
authors.initials: KR
authors.lastname: Koh
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.forename: M
authors.initials: M
authors.lastname: Ohsawa
authors.forename: K
authors.initials: K
authors.lastname: Wakasa
authors.forename: M
authors.initials: M
authors.lastname: Hino
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001739:BK Virus / Q000302:isolation & purification*; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D027601:Polyomavirus Infections / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014412:Tumor Virus Infections / Q000188:drug therapy / Q000473:pathology / Q000821:virology*
chemical_list: D000998:Antiviral Agents