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International Journal of Hematology

, Volume 95, Issue 2, pp 217–222 | Cite as

A fatal case of cytomegalovirus ventriculoencephalitis in a mycosis fungoides patient who received multiple umbilical cord blood cell transplantations

  • Toshihiro MatsukawaEmail author
  • Hideki Goto
  • Kenta Takahashi
  • Shinsuke Asanuma
  • Atsushi Yasumoto
  • Mutsumi Takahata
  • Akio Shigematsu
  • Tomoyuki Endo
  • Junji Tanaka
  • Satoshi Hashino
  • Shinya Tanaka
  • Masahiro Imamura
Case Report

Abstract

Cytomegalovirus (CMV) infection is latent in the majority of adult humans. The reactivation of CMV causes pneumonia and gastrointestinal disease in severely immunosuppressed patients, who consequently suffer very high mortality due to CMV central nervous system disease. We report here a case involving a 28-year-old female patient with mycosis fungoides who underwent umbilical cord blood transplantation three times and developed CMV ventriculoencephalitis. The patient’s CMV viremia was successfully preempted with ganciclovir (GCV) as indicated by undetectable CMV antigenemia; despite this successful treatment, the patient developed CMV ventriculoencephalitis. Foscarnet (FCV) therapy led to a temporary recovery, after which CMV ventriculoencephalitis recurred, and the patient died after receiving combination GCV and FCV therapy. Autopsy samples revealed CMV ventriculoencephalitis, as indicated by numerous inclusion-bearing cells (Owl’s eye). It is likely that this patient harbored a GCV-resistant CMV strain; however, it was not possible to obtain nucleic acids suitable for use in assessing this possibility.

Keywords

Cytomegalovirus ventriculoencephalitis Ganciclovir resistance Umbilical cord blood transplantation Mycosis fungoides Inclusion-bearing cells 

Notes

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© The Japanese Society of Hematology 2012

Authors and Affiliations

  • Toshihiro Matsukawa
    • 1
    Email author
  • Hideki Goto
    • 1
  • Kenta Takahashi
    • 2
  • Shinsuke Asanuma
    • 1
  • Atsushi Yasumoto
    • 1
  • Mutsumi Takahata
    • 1
  • Akio Shigematsu
    • 1
  • Tomoyuki Endo
    • 1
  • Junji Tanaka
    • 1
  • Satoshi Hashino
    • 1
  • Shinya Tanaka
    • 2
  • Masahiro Imamura
    • 1
  1. 1.Stem Cell Transplantation CenterHokkaido University HospitalSapporoJapan
  2. 2.Department of Pathology, Laboratory of Cancer ResearchHokkaido University Graduate School of MedicineSapporoJapan

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