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Transplantation:
27 January 2001 - Volume 71 - Issue 2 - pp 288-292
Clinical Transplantation

Fatal Primary Infection Due To Human Herpesvirus 6 Variant A in A Renal Transplant Recipient

Rossi, Camelia; Delforge, Marie-Luce; Jacobs, Fredrique; Wissing, Martin; Pradier, Olivier; Remmelink, Myriam; Byl, Baudouin; Thys, Jean-Pierre; Liesnard, Corinne

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Abstract

We describe a fatal primary human herpesvirus 6 (HHV-6) variant A infection in a kidney transplanted adult woman. On day 20 post transplantation (TX), after rejection therapy, the patient presented an acute hemophagocytic syndrome with hepatitis and central nervous system involvement. HHV-6 IgG and IgM antibodies seroconversion was demonstrated. HHV-6 variant A was the sole pathogen detected by nested PCR and/or culture in blood, bone marrow aspiration, liver biopsy, cerebrospinal fluid and bronchoalveolar lavage. The graft was HHV-6 seropositive and the patient was not transfused before day 28 post TX, suggesting that the virus was transmitted by the graft. Despite immunoglobulins, ganciclovir and foscarnet therapy, the HHV-6 infection progressed and led to severe aplasia. The patient developed Aspergillus fumigatus pneumonia and died from fulminant candidemia. This case demonstrated for the first time that HHV-6 variant A primary infection can cause life-threatening disseminated infection in immunosuppressed patients.

© 2001 Lippincott Williams & Wilkins, Inc.

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