Journal Article

Cytomegalovirus Ventriculoencephalitis in a Peripheral Blood Stem Cell Transplant Recipient

Geraldine G. Miller, Guy Boivin, J. Stephen Dummer, Thomas McConnell, Mark W. Becher, Adetola Kassim and Yi-Wei Tang

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 42, issue 4, pages e26-e29
Published in print February 2006 | ISSN: 1058-4838
Published online February 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/499366
Cytomegalovirus Ventriculoencephalitis in a Peripheral Blood Stem Cell Transplant Recipient

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Cytomegalovirus encephalitis occurs rarely in transplant recipients. We describe a patient with cytomegalovirus ventriculoencephalitis who had a very high CSF viral load but a low peripheral blood viral load. No resistance mutations were present in cerebrospinal fluid viral DNA, whereas DNA from blood showed a resistance mutation in the UL54 gene but not in the UL97 gene. Viral replication was intense in the brain ependyma and periventricular areas without evidence of peripheral cytomegalovirus disease. The data provide evidence for compartmentalization of cytomegalovirus infection. Levels of ganciclovir and foscarnet in the cerebrospinal fluid may be inadequate for treatment, even for some drug-susceptible strains, and, together with periventricular replication, may explain the disparity between cerebrospinal fluid viral load and peripheral blood viral load.

Journal Article.  2204 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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