Molnupiravir Treatment Associated With Clearance of Cache Valley Virus From Cerebrospinal Fluid in an Immunocompromised Child With Meningoencephalitis

Destini Smith Byrd; Amitha Ananth; Claire McDonald; T Prescott Atkinson; Charles Y Chiu; David W Kimberlin; Lydia Marcus

doi:10.1093/ofid/ofag217

Molnupiravir Treatment Associated With Clearance of Cache Valley Virus From Cerebrospinal Fluid in an Immunocompromised Child With Meningoencephalitis

Open Forum Infect Dis. 2026 Apr 18;13(5):ofag217. doi: 10.1093/ofid/ofag217. eCollection 2026 May.

Authors

Destini Smith Byrd¹, Amitha Ananth², Claire McDonald², T Prescott Atkinson², Charles Y Chiu³, David W Kimberlin², Lydia Marcus²

Affiliations

¹ Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.
² Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
³ Department of Medicine, University of California, SanFrancisco, San Francisco, California, USA.

Abstract

Cache Valley virus is a bunyavirus endemic to North America, commonly infecting livestock, but known to cause meningoencephalitis in immunocompromised humans in rare cases. We present the first known pediatric case of Cache Valley virus encephalitis in an adolescent with IKZF1/Ikaros immunodeficiency with viral clearance from cerebrospinal fluid after molnupiravir antiviral therapy.

Keywords: Pediatric; cache valley virus; encepahlitis; immunodeficiency.