The Successful Treatment of a Cord Blood Transplant Recipient with Varicella Zoster Virus Meningitis, Radiculitis and Myelitis with Foscarnet.
Infections of the central nervous system (CNS) with varicella zoster virus (VZV) is a rare occurrence after allogeneic hematopoietic stem cell transplantation. We herein report a case of VZV meningitis, radiculitis and myelitis that developed 8 months after cord blood transplantation, shortly after the cessation of cyclosporine and low-dose acyclovir. Although treatment with acyclovir did not achieve a satisfactory response, the patient was successfully treated with foscarnet. Our report indicates that VZV infection should be considered in allo-hematopoietic stem cell transplantation (HSCT) patients with CNS symptoms and that foscarnet may be effective for the treatment of acyclovir-resistant VZV infections of the CNS. The development of optimal prophylactic strategies and vaccination schedules may eradicate post-transplant VZV disease.
Department of Hematology, Chiba University Hospital, Japan.
Ryo
R
Shimizu
Chikako
C
Ohwada
Yuhei
Y
Nagao
Emi
E
Togasaki
Chika
C
Kawajiri
Tomoya
T
Muto
Shokichi
S
Tsukamoto
Shio
S
Sakai
Yusuke
Y
Takeda
Naoya
N
Mimura
Masahiro
M
Takeuchi
Emiko
E
Sakaida
Tohru
T
Iseki
Chiaki
C
Nakaseko
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D017245:Foscarnet / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006562:Herpes Zoster / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D008587:Meningitis, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014184:Transplantation, Homologous / Q000009:adverse effects
D000998:Antiviral Agents; D017245:Foscarnet; D000212:Acyclovir