Rossi C, Delforge M L, Jacobs F, Wissing M, Pradier O, Remmelink M, Byl B, Thys J P, Liesnard C
Infectious Diseases Clinic, Department of Nephrology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Transplantation. 2001 Jan 27;71(2):288-92. doi: 10.1097/00007890-200101270-00021.
We describe a fatal primary human herpesvirus 6 (HHV-6) variant A infection in a kidney transplanted adult woman. On day 20 post transplantation (TX), after rejection therapy, the patient presented an acute hemophagocytic syndrome with hepatitis and central nervous system involvement. HHV-6 IgG and IgM antibodies seroconversion was demonstrated. HHV-6 variant A was the sole pathogen detected by nested PCR and/or culture in blood, bone marrow aspiration, liver biopsy, cerebrospinal fluid and bronchoalveolar lavage. The graft was HHV-6 seropositive and the patient was not transfused before day 28 post TX, suggesting that the virus was transmitted by the graft. Despite immunoglobulins, ganciclovir and foscarnet therapy, the HHV-6 infection progressed and led to severe aplasia. The patient developed Aspergillus fumigatus pneumonia and died from fulminant candidemia. This case demonstrated for the first time that HHV-6 variant A primary infection can cause life-threatening disseminated infection in immunosuppressed patients.
我们描述了一例肾移植成年女性发生的致命性原发性人疱疹病毒6型（HHV-6）A变种感染。移植后第20天（TX），在抗排斥治疗后，患者出现伴有肝炎及中枢神经系统受累的急性噬血细胞综合征。检测到HHV-6 IgG和IgM抗体血清学转换。通过巢式PCR和/或培养在血液、骨髓穿刺物、肝活检组织、脑脊液和支气管肺泡灌洗物中检测到HHV-6 A变种是唯一的病原体。移植物HHV-6血清学阳性，且患者在移植后第28天之前未接受输血，提示病毒是通过移植物传播的。尽管给予了免疫球蛋白、更昔洛韦和膦甲酸钠治疗，HHV-6感染仍进展并导致严重发育不全。患者发生烟曲霉肺炎并死于暴发性念珠菌血症。该病例首次证明HHV-6 A变种原发性感染可在免疫抑制患者中引起危及生命的播散性感染。
