Intact survival of refractory CMV limbic encephalitis in a patient with severe aplastic anemia after unrelated bone marrow transplantation

J Pediatr Hematol Oncol. 2012 Aug;34(6):472-4. doi: 10.1097/MPH.0b013e318243501b.


We described a patient of refractory cytomegalovirus (CMV) limbic encephalitis who received matched unrelated bone marrow transplantation. Pyrosequencing study on serial cerebrospinal fluid samples revealed the emergence of resistant strains associated with exposure of antiviral agents. Combinations of antiviral agents had a role in partial suppression of CMV viral load but the clearance of virus mainly relied on the recovery of host's immunity and resulted in intact survival of host. Donor's CMV-seronegative status may contribute to the delay in controlling this serious infection. Prompt identification of drug-resistant mutant helps in selection of antiviral agents.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Aplastic / complications
  • Anemia, Aplastic / therapy*
  • Antiviral Agents / therapeutic use
  • Child
  • Cytomegalovirus / pathogenicity
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / virology
  • Drug Resistance, Viral*
  • Female
  • Ganciclovir / therapeutic use*
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / mortality
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Limbic Encephalitis / diagnosis
  • Limbic Encephalitis / etiology*
  • Limbic Encephalitis / mortality*
  • Prognosis
  • Retinitis / diagnosis
  • Retinitis / etiology
  • Retinitis / mortality
  • Survival Rate


  • Antiviral Agents
  • Ganciclovir