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Intact Survival of Refractory CMV Limbic Encephalitis in a Patient With Severe Aplastic Anemia After Unrelated Bone Marrow Transplantation

Tam, Dorothy Yuen Shan MRCPCH; Cheng, Frankie Wai Tsoi MD; Chan, Paul Kay Sheung MD; Leung, Wing Kwan MRCPCH; Lee, Vincent MRCP; Shing, Ming Kong FRCP; Cheung, Jo Lai Ken BSc; Li, Chi Kong MD

Journal of Pediatric Hematology/Oncology: August 2012 - Volume 34 - Issue 6 - p 472–474
doi: 10.1097/MPH.0b013e318243501b
Clinical and Laboratory Observations

We described a patient of refractory cytomegalovirus (CMV) limbic encephalitis who received matched unrelated bone marrow transplantation. Pyrosequencing study on serial cerebrospinal fluid samples revealed the emergence of resistant strains associated with exposure of antiviral agents. Combinations of antiviral agents had a role in partial suppression of CMV viral load but the clearance of virus mainly relied on the recovery of host’s immunity and resulted in intact survival of host. Donor’s CMV-seronegative status may contribute to the delay in controlling this serious infection. Prompt identification of drug-resistant mutant helps in selection of antiviral agents.

*Department of Paediatrics, Prince of Wales Hospital

Department of Microbiology, The Chinese University of Hong Kong, New Territories, Hong Kong

The authors declare no conflict of interest.

Reprints: Frankie Wai Tsoi Cheng, MD, Department of Paediatrics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (e-mail: frankiecheng@cuhk.edu.hk).

Received August 23, 2011

Accepted November 14, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.