title: Treatment of Chronic Enterovirus Encephalitis With Fluoxetine in a Patient With X-Linked Agammaglobulinemia.
abstract: Enterovirus may result in a devastating chronic encephalitis in immunocompromised patients, particularly in patients with X-linked agammaglobulinemia. Prognosis for patients with chronic enterovirus encephalitis is poor, almost invariably resulting in mortality without specific treatment. There are currently no approved antiviral agents for enterovirus, but the antidepressant drug fluoxetine has been identified through library-based compound screening as a potential anti-enteroviral agent in vitro. However, use of fluoxetine has not previously been studied in humans with enteroviral disease.
  
  
  
  A five year old boy with X-linked agammaglobulinemia presented with progressive neurological deterioration and was found to have chronic enterovirus encephalitis by brain biopsy. He failed to respond to standard treatment with high dose intravenous immunoglobulin, but showed stabilization and improvement following treatment with fluoxetine.
  
  
  
  This is the first report to describe the use of fluoxetine as a potential therapy for chronic enterovirus infection. Further investigation of fluoxetine as a treatment option for chronic enterovirus encephalitis is necessary.
authors.affiliation: Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: gofshteynj@email.chop.edu.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Gofshteyn
authors.affiliation: Division of Pathology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Cárdenas
authors.affiliation: Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Bearden
mesh_terms: D000361:Agammaglobulinemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D000998:Antiviral Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D002908:Chronic Disease; D018792:Encephalitis, Viral / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D004769:Enterovirus Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D005473:Fluoxetine / Q000627:therapeutic use*; D040181:Genetic Diseases, X-Linked / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male
chemical_list: D000998:Antiviral Agents; D005473:Fluoxetine
keywords: X-linked agammaglobulinemia; enterovirus; enterovirus encephalitis; fluoxetine