Fatal herpesvirus-6 encephalitis in a recipient of a T-cell-depleted peripheral blood stem cell transplant from a 3-loci mismatched related donor

Human herpesvirus-6 (HHV-6), like all the other herpes viruses, remains lat ent in host cells after primary infection but can be reactivated In immuno- compromised patients causing fever, skin rash, bone marrow (BM) suppression , pneumonitis, Sinusitis and meningoencephalitis. We describe the case of a man with chronic myelogenous leukemia who developed encephalitis associate d with acute graft-versus-host disease two months after a T-cell-depleted m ismatched peripheral blood stem cell transplant. Magnetic resonance images of the brain revealed multiple bilateral foci of signal abnormality. HHV-6 was the only pathogen detected in cerebrospinal fluid by PCR. treatment wit h both ganciclovir and foscarnet was unsuccessful and the patient gradually deteriorated and died. Other cases of HHV-6 encephalitis after bone marrow transplantation are reviewed. (C) 2000. Ferrata Storti Foundation.