Cytomegalovirus (CMV) is a ubiquitous herpesvirus which establishes lifelong latency following primary infection. It is then capable of reactivating in the face of immunosuppression. Encephalitis is a less common, but particularly devastating syndrome associated with CMV. Here, we describe a case of CMV encephalitis in an allogeneic hematopoietic stem cell transplant recipient who received dual antiviral therapy with ganciclovir and foscarnet. The case presentation is followed by a summary of cases reported in the last ten years, with the goal of describing vulnerable patient populations, treatment courses, and outcomes. Finally, the discussion includes a review of the literature, with a focus on diagnostic criteria and the role for dual antiviral therapy in CMV encephalitis.
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http://dx.doi.org/10.1016/j.jns.2018.02.029 | DOI Listing |
Viruses
December 2024
Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Cytomegalovirus (CMV) infection in solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients may increase the risk of rejection or allograft dysfunction, other infection(s), and morbidity and mortality. Treatment can be challenging due to medication-associated toxicities. Maribavir (MBV) is a promising option for the treatment of resistant or refractory (R/R) CMV infection in lieu of foscarnet (FOS), which has long been the recommended therapy for (val)ganciclovir-resistant infection.
View Article and Find Full Text PDFZhonghua Xue Ye Xue Za Zhi
November 2024
The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China.
This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy. This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed.
View Article and Find Full Text PDFJ Inflamm Res
December 2024
Department of Ophthalmology, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
Human herpesvirus 6 (HHV-6) infection can cause ophthalmic diseases in immunocompetent patients, recipients of bone marrow transplants, and patients with acquired immunodeficiency syndrome (AIDS). This study describes the case of a healthy 37-year-old male who presented with unilateral anterior uveitis (AU), significant anterior chamber exudation, pupillary membrane closure, increased intraocular pressure, and eyelid edema. Notably, HHV-6A was the only pathogenic agent identified in the blood and aqueous humor.
View Article and Find Full Text PDFYale J Biol Med
December 2024
Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
: To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in a patient with previous history of cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated with tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. : The clinical records of the case were reviewed, focusing on demographics, image findings, and clinical course. : A 17-year-old female with a past medical history of T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented with active CMV retinitis.
View Article and Find Full Text PDFClin Microbiol Infect
December 2024
Institute of Medical Microbiology and Virology, University Medical Center, Göttingen, Germany.
Background: Despite established antiviral therapy for herpes simplex virus, varicella zoster and cytomegalovirus encephalitis, the outcome remains poor.
Objectives: To assess pharmacokinetic (PK) and pharmacodynamic (PD) data of antiviral drugs in the central nervous system (CNS) to optimize the treatment of Herpesviridae encephalitis.
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