Psychotic symptoms and confusion associated with intravenous ganciclovir in a heart transplant recipient

A 65-year-old man underwent orthotopic cardiac transplantation and was prop hylactically treated for cytomegalovirus infection with intravenous gancicl ovir. He received standard dosages and had normal renal function. After 6 d ays of therapy he. experienced psychotic symptoms with hallucinations, conf usion, and disorientation. His altered mental status resolved after the dru g had been discontinued for 5 days. Ganciclovir was suspected as a cause of the symptoms, Alternative etiologies of were explored and excluded.