Pang Ian, Singhabahu Sanjay, Novitzky-Basso Igor, Mazzulli Tony, Husain Shahid, Mattsson Jonas
Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Toronto, ON M5G 2C1, Canada.
Department of Microbiology, Sinai Health System/University Health Network, 600 University Ave, Toronto, ON M5G 1X5, Canada.
IDCases. 2022 Aug 19;29:e01608. doi: 10.1016/j.idcr.2022.e01608. eCollection 2022.
We report the outcome of a 43 year old man who developed fatal ventriculoencephalitis due to cytomegalovirus (CMV) infection 7 months post allogeneic stem cell transplant. He failed multiple lines of treatment, including intravenous ganciclovir, foscarnet, and CMV-specific immunoglobulins, without improvement in CSF CMV copies. Novel intrathecal administration of CMV immunoglobulins was given but did not lead to clearance of CMV from CSF. No adverse effects related to intrathecal CMV immunoglobulins were observed. Notably, throughout this period, CMV in blood remained undetectable. This case highlights the difficulty in treating CMV encephalitis, and that novel therapeutic approaches are needed.
我们报告了一名43岁男性的病例，该患者在异基因干细胞移植后7个月因巨细胞病毒（CMV）感染发展为致命性脑室脑炎。他接受了多线治疗均告失败，包括静脉注射更昔洛韦、膦甲酸钠和CMV特异性免疫球蛋白，脑脊液中CMV拷贝数并无改善。给予了新型鞘内注射CMV免疫球蛋白，但未使脑脊液中的CMV清除。未观察到与鞘内注射CMV免疫球蛋白相关的不良反应。值得注意的是，在此期间，血液中的CMV一直未被检测到。该病例凸显了治疗CMV脑炎的困难，以及需要新的治疗方法。
