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

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

来源：International Journal of Hematology, 2012, 95(2): 217-222.

DOI：10.1007/s12185-012-1003-3

• Cytomegalovirus ventriculoencephalitis
• Ganciclovir resistance
• Umbilical cord blood transplantation
• Mycosis fungoides
• Inclusion-bearing cells

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%26apos;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%26apos;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.

• 出版日期2012-2