title: Primary Polyomavirus Infection, Not Reactivation, as the Cause of Trichodysplasia Spinulosa in Immunocompromised Patients.
abstract: Classic human polyomaviruses (JC and BK viruses) become pathogenic when reactivating from latency. For the rare skin disease trichodysplasia spinulosa, we show that manifestations of the causative polyomavirus (TSPyV) occur during primary infection of the immunosuppressed host. High TSPyV loads in blood and cerebrospinal fluid, sometimes coinciding with cerebral lesions and neuroendocrine symptoms, marked the acute phase of trichodysplasia spinulosa, whereas initiation and maturation of TSPyV seroresponses occurred in the convalescent phase. TSPyV genomes lacked the rearrangements typical for reactivating polyomaviruses. These findings demonstrate the clinical importance of primary infection with this rapidly expanding group of human viruses and explain the rarity of some novel polyomavirus-associated diseases.
authors: Department of Medical Microbiology, Leiden University Medical Center.
authors: Els
authors: E
authors: van der Meijden
authors: Departments of Dermatology.
authors: Barbara
authors: B
authors: Horváth
authors: Hematology.
authors: Marcel
authors: M
authors: Nijland
authors: Departments of Dermatology.
authors: Karin
authors: K
authors: de Vries
authors: Departments of Dermatology.
authors: Emo Ke
authors: EK
authors: Rácz
authors: Pathology, and.
authors: Gilles F
authors: GF
authors: Diercks
authors: Internal Medicine.
authors: Annelies E
authors: AE
authors: de Weerd
authors: Pathology, and.
authors: Marian C
authors: MC
authors: Clahsen-van Groningen
authors: Department of Medical Microbiology, Leiden University Medical Center.
authors: Caroline S
authors: CS
authors: van der Blij-de Brouwer
authors: Department of Medical Microbiology, Leiden University Medical Center.
authors: Arnulfo J
authors: AJ
authors: van der Zon
authors: Department of Medical Microbiology, Leiden University Medical Center.
authors: Aloys C M
authors: ACM
authors: Kroes
authors: Department of Virology, University of Helsinki and Helsinki University Hospital, Finland.
authors: Klaus
authors: K
authors: Hedman
authors: Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands; and.
authors: Jeroen J A
authors: JJA
authors: van Kampen
authors: Medical Microbiology, University of Groningen, University Medical Center Groningen, and.
authors: Annelies
authors: A
authors: Riezebos-Brilman
authors: Department of Medical Microbiology, Leiden University Medical Center.
authors: Mariet C W
authors: MCW
authors: Feltkamp
mesh_terms: D002555:Cerebrospinal Fluid / Q000821:virology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011120:Polyomavirus; D027601:Polyomavirus Infections / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000821:virology*; D019562:Viral Load
keywords: cidofovir; dissemination; polyomavirus; primary infection; reactivation; trichodysplasia spinulosa; viral load