Varicella zoster virus meningoencephalitis after allogeneic hematopoietic stem cell transplantation

J. Suzuki, M. Ashizawa, S. Okuda, H. Wada, K. Sakamoto, K. Terasako, M. Sato, S. I. Kimura, M. Kikuchi, H. Nakasone, S. Kako, Rie Yamazaki, K. Oshima, J. Nishida, Y. Kanda

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Although the reactivation of varicella zoster virus (VZV) is a common complication after allogeneic hematopoietic stem cell transplantation (HSCT), VZV meningoencephalitis is a rare life-threatening infectious disease after HSCT. We describe here a patient who developed VZV meningoencephalitis 2 years after human leukocyte antigen-matched unrelated HSCT for acute myeloblastic leukemia. She developed chronic graft-versus-host disease, and cyclosporine (CSA) was continued until 17 months after HSCT. Low-dose acyclovir (ACV) at 200 mg/day was administered to prevent the reactivation of VZV from day -7 to the termination of CSA. At 22 months, she suddenly developed fever, loss of consciousness, and seizure, with generalized skin rash. A high level of VZV DNA was detected in her cerebrospinal fluid (CSF). She was diagnosed to have VZV meningoencephalitis. Intravenous ACV at 30 mg/kg/day was given for 2 months. Although loss of consciousness was quickly resolved, some neurologic symptoms persisted. She did not have any known risk factors for VZV reactivation. Therefore, we should keep in mind that any HSCT recipient may develop VZV meningoencephalitis, and examination of CSF for VZV infection with an empiric administration of ACV may be recommended for HSCT recipients with central nervous system symptoms, even in the absence of skin manifestations.

Original languageEnglish
JournalTransplant Infectious Disease
Volume14
Issue number4
DOIs
Publication statusPublished - 2012 Aug 1
Externally publishedYes

Fingerprint

Meningoencephalitis
Human Herpesvirus 3
Hematopoietic Stem Cell Transplantation
Acyclovir
Unconsciousness
Cerebrospinal Fluid
Skin Manifestations
Graft vs Host Disease
Virus Diseases
HLA Antigens
Neurologic Manifestations
Exanthema
Acute Myeloid Leukemia
Cyclosporine
Communicable Diseases
Seizures
Fever
Central Nervous System
DNA

Keywords

  • Hematopoietic stem cell transplantation
  • Meningoencephalitis
  • Varicella zoster virus

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

Varicella zoster virus meningoencephalitis after allogeneic hematopoietic stem cell transplantation. / Suzuki, J.; Ashizawa, M.; Okuda, S.; Wada, H.; Sakamoto, K.; Terasako, K.; Sato, M.; Kimura, S. I.; Kikuchi, M.; Nakasone, H.; Kako, S.; Yamazaki, Rie; Oshima, K.; Nishida, J.; Kanda, Y.

In: Transplant Infectious Disease, Vol. 14, No. 4, 01.08.2012.

Research output: Contribution to journalArticle

Suzuki, J, Ashizawa, M, Okuda, S, Wada, H, Sakamoto, K, Terasako, K, Sato, M, Kimura, SI, Kikuchi, M, Nakasone, H, Kako, S, Yamazaki, R, Oshima, K, Nishida, J & Kanda, Y 2012, 'Varicella zoster virus meningoencephalitis after allogeneic hematopoietic stem cell transplantation', Transplant Infectious Disease, vol. 14, no. 4. https://doi.org/10.1111/j.1399-3062.2012.00720.x
Suzuki, J. ; Ashizawa, M. ; Okuda, S. ; Wada, H. ; Sakamoto, K. ; Terasako, K. ; Sato, M. ; Kimura, S. I. ; Kikuchi, M. ; Nakasone, H. ; Kako, S. ; Yamazaki, Rie ; Oshima, K. ; Nishida, J. ; Kanda, Y. / Varicella zoster virus meningoencephalitis after allogeneic hematopoietic stem cell transplantation. In: Transplant Infectious Disease. 2012 ; Vol. 14, No. 4.
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