A fatal case of cytomegalovirus ventriculoencephalitis in a mycosis fungoides patient who received multiple umbilical cord blood cell transplantations

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Author(s)

    • GOTO Hideki
    • Stem Cell Transplantation Center, Hokkaido University Hospital
    • TAKAHASHI Kenta
    • Department of Pathology, Laboratory of Cancer Research, Hokkaido University Graduate School of Medicine
    • ENDO Tomoyuki
    • Stem Cell Transplantation Center, Hokkaido University Hospital
    • TANAKA Junji
    • Stem Cell Transplantation Center, Hokkaido University Hospital
    • TANAKA Shinya
    • Department of Pathology, Laboratory of Cancer Research, Hokkaido University Graduate School of Medicine

Abstract

Cytomegalovirus (CMV) infection is latent in the majority of adult humans. The reactivation of CMV causes pneumonia and gastrointestinal disease in severely immunosuppressed patients, who consequently suffer very high mortality due to CMV central nervous system disease. We report here a case involving a 28-year-old female patient with mycosis fungoides who underwent umbilical cord blood transplantation three times and developed CMV ventriculoencephalitis. The patient's CMV viremia was successfully preempted with ganciclovir (GCV) as indicated by undetectable CMV antigenemia, but despite this successful treatment, the patient developed CMV ventriculoencephalitis. Foscarnet (FCV) therapy led to a temporary recovery, after which CMV ventriculoencephalitis recurred and the patient died after receiving combination GCV and FCV therapy. Autopsy samples revealed CMV ventriculoencephalitis, as indicated by numerous inclusion-bearing cells (Owl's eye). It is likely that this patient harbored a GCV-resistant CMV strain; however, it was not possible to obtain nucleic acids suitable for use in assessing this possibility.

Journal

  • International Journal of Hematology

    International Journal of Hematology 95(2), 217-222, 2012-02-01

    Springer Japan

References:  29

Codes

  • NII Article ID (NAID)
    10030267530
  • NII NACSIS-CAT ID (NCID)
    AA10797094
  • Text Lang
    ENG
  • Article Type
    NOT
  • ISSN
    09255710
  • Data Source
    CJP  IR 
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