title: An emerging opportunistic infection: fatal astrovirus (VA1/HMO-C) encephalitis in a pediatric stem cell transplant recipient.
abstract: Neuroinvasive astrovirus (VA1-HMO-C) is an emerging life-threatening infection in immunocompromised hosts. We describe an 8-month-old child who died of VA1/HMO-C encephalitis following bone marrow transplantation. The diagnosis was only made post-mortem using RNA deep sequencing of the brain. Repeat analysis of the post-mortem brain tissue using polymerase chain reaction specific primers for VA1/HMO-C was positive. Astrovirus VA1/HMO-C should be included in the evaluation of patients with similar encephalitis.
authors.affiliation: Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Su Han
authors.initials: SH
authors.lastname: Lum
authors.affiliation: Clinical Virology Department, Manchester Royal Infirmary, Manchester, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Turner
authors.affiliation: Clinical Virology Department, Manchester Royal Infirmary, Manchester, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Guiver
authors.affiliation: Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Denise
authors.initials: D
authors.lastname: Bonney
authors.affiliation: Department of Neurology, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Timorthy
authors.initials: T
authors.lastname: Martland
authors.affiliation: Clinical Virology Department, Manchester Royal Infirmary, Manchester, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Davies
authors.affiliation: Diagnostic Paediatric Histopathology Service, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Newbould
authors.affiliation: Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children, London, UK.
authors.forename: Julianne
authors.initials: J
authors.lastname: Brown
authors.affiliation: Research Department of Infection, Division of Infection and Immunity, University College of London, London, UK.
authors.forename: Sofia
authors.initials: S
authors.lastname: Morfopoulou
authors.affiliation: Research Department of Infection, Division of Infection and Immunity, University College of London, London, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Breuer
authors.affiliation: Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Wynn
mesh_terms: D019350:Astroviridae Infections / Q000821:virology*; D001706:Biopsy; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002879:Chromosomes, Human, Pair 10 / Q000235:genetics; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics; D003967:Diarrhea / Q000209:etiology; D018792:Encephalitis, Viral / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D004751:Enteritis / Q000150:complications / Q000821:virology; D017809:Fatal Outcome; D005243:Feces / Q000821:virology; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D001257:Mamastrovirus / Q000302:isolation & purification*; D009894:Opportunistic Infections / Q000821:virology*; D012367:RNA, Viral / Q000302:isolation & purification; D017423:Sequence Analysis, RNA; D014178:Translocation, Genetic; D019172:Transplantation Conditioning / Q000009:adverse effects*
chemical_list: D007166:Immunosuppressive Agents; D012367:RNA, Viral
keywords: 
  BMT
  ; astrovirus VA1-HMO-C; deep brain sequencing; unexplained encephalitis