title: A case of severe ganciclovir-induced encephalopathy.
abstract: BACKGROUND
  Ganciclovir, a drug against cytomegalovirus (CMV) infection, is generally well tolerated, but can cause neurotoxicity such as encephalopathy. Although ganciclovir-induced encephalopathy has been described in several reports, a literature search revealed that ganciclovir concentrations in the blood or cerebrospinal fluid were previously measured in only 3 patients with encephalopathy. Symptoms usually include confusion and disturbed consciousness, which mimic CMV encephalitis. Prompt and accurate diagnosis is thus sometimes difficult, and is derived solely from accumulated clinical information of definite cases, since ganciclovir concentrations, not routinely measured, become available after several days or a few weeks.
  
  
  METHODS
  Here, we summarize clinical information of all patients with definite ganciclovir-induced encephalopathy including our own patient, who had severe symptoms, with the highest reported trough concentration of ganciclovir in the blood, and underwent therapeutic dialysis with complete recovery.
  
  
  CONCLUSIONS
  Our summary of patients with definite encephalopathy could lead to prompt and accurate diagnoses.
authors.affiliation: Department of Neurology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Sakamoto
authors.affiliation: Department of Neurology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan ; Department of Department of Neurology, Kinki University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Makito
authors.initials: M
authors.lastname: Hirano
authors.affiliation: Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nose
authors.affiliation: Department of Neurology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
authors.affiliation: Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nishioka
authors.affiliation: Department of Department of Neurology, Kinki University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
authors.affiliation: Department of Neurology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan.
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Nakamura
keywords: Cytomegalovirus enteritis; Dialysis; Encephalopathy; Ganciclovir; Kidney transplantation