PROLONGED ENTEROVIRAL INFECTION IN A PATIENT WHO DEVELOPED PERICARDITIS AND HEART-FAILURE AFTER BONE-MARROW TRANSPLANTATION

We describe a patient who developed heart failure and pericarditis aft er bone marrow transplantation for a hematologic malignancy. The patie nt died of heart failure complicated by pneumonia. Despite extensive s urveillance, an infectious cause for the heart failure was not found w hile he was alive. In addition, cultures of specimens obtained at auto psy did not reveal a cause for the heart failure. Enterovirus was dete cted by the polymerase chain reaction (PCR) in two samples of pleural fluid that were obtained 21 days apart while he was alive. After the p atient died, enteroviral RNA was also detected in his lungs, liver, an d spleen, indicating a generalized infection. Analysis of the PCR prod ucts revealed sequences sharing close homology with the coxsackie B-li ke group of enteroviruses. In addition to reporting this case, we revi ew the literature regarding enteroviral infections after transplantati on.