title: BK polyomavirus encephalitis in a patient with thrombotic microangiopathy after an allogeneic hematopoietic stem cell transplant.
abstract: To date, only one case of BK polyomavirus (BKPyV) encephalitis combined with transplant-associated thrombotic microangiopathy has been reported in an hematopoietic stem cell transplantation (HCT) recipient. We report the case of an HCT recipient who developed thrombotic microangiopathy and subsequent BKPyV encephalitis. She died despite treatment with cidofovir, ciprofloxacin, and intravenous immunoglobulin without improvement in mental status. Early suspicion of BKPyV encephalitis in an HCT recipient presenting with altered mental status and hemorrhagic cystitis is important.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Jae-Bum
authors.initials: JB
authors.lastname: Jun
authors.affiliation: Division of Hematology and Cellular Therapy, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Yunsuk
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Division of Hematology and Cellular Therapy, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Hawk
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Joseph
authors.initials: J
authors.lastname: Jeong
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Jiwon
authors.initials: J
authors.lastname: Jung
mesh_terms: D000743:Anemia, Hemolytic / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001739:BK Virus / Q000302:isolation & purification* / Q000502:physiology; D000077404:Cidofovir; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D003556:Cystitis / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D027601:Polyomavirus Infections / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000821:virology; D057049:Thrombotic Microangiopathies / Q000150:complications* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous / Q000009:adverse effects; D014412:Tumor Virus Infections / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000821:virology; D014775:Virus Activation / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D063065:Organophosphonates; D002939:Ciprofloxacin; D003596:Cytosine; D000077404:Cidofovir
keywords: BK virus; cidofovir; encephalitis; hematopoietic stem cell transplantation; transplant-associated thrombotic microangiopathy