Enteroviral meningoencephalitis in immunocompromised children after matched unrelated donor-bone marrow transplantation

Two children are described who presented with fever and generalized seizure s, days 50 and 200, respectively after matched unrelated donor-bone marrow transplantation. Upon antiepileptic treatment the seizures vanished but som nolence and fever remained, Magnetic resonance imaging (MRI) of the brain w as performed and revealed transient asymmetric multifocal hyperintense lesi ons. Seizures were considered related to infection, and the cyclosporin A ( CsA) treatment was not interrupted. Enterovirus was detected by reverse tra nscriptase-polymerase chain reaction in the spinal fluid of one patient and in the sputum of the other: Both children recovered completely within the next weeks without neurological sequel. This report shows that enteroviral meningoencephalitis can present with seizures during the post-transplant pe riod. It highlights the importance of MRI for neuroimaging and of viral inf ections as differential diagnosis to CsA neurotoxicity.