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01-02-2012 | Case Report

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

Authors: Toshihiro Matsukawa, Hideki Goto, Kenta Takahashi, Shinsuke Asanuma, Atsushi Yasumoto, Mutsumi Takahata, Akio Shigematsu, Tomoyuki Endo, Junji Tanaka, Satoshi Hashino, Shinya Tanaka, Masahiro Imamura

Published in: International Journal of Hematology | Issue 2/2012

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; 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.

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Title: A fatal case of cytomegalovirus ventriculoencephalitis in a mycosis fungoides patient who received multiple umbilical cord blood cell transplantations
Authors: Toshihiro Matsukawa
Hideki Goto
Kenta Takahashi
Shinsuke Asanuma
Atsushi Yasumoto
Mutsumi Takahata
Akio Shigematsu
Tomoyuki Endo
Junji Tanaka
Satoshi Hashino
Shinya Tanaka
Masahiro Imamura
Publication date: 01-02-2012
Publisher: Springer Japan
Published in: International Journal of Hematology / Issue 2/2012
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI: https://doi.org/10.1007/s12185-012-1003-3

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