Encephalitis caused by an unusual human herpes virus type 6 and Toxoplasma gondii co-infection in a cord blood transplant recipient

Int J Infect Dis. 2016 May:46:79-81. doi: 10.1016/j.ijid.2016.04.002. Epub 2016 Apr 6.

Abstract

Background: The case of a central nervous system human herpes virus type 6 (HHV-6) and Toxoplasma gondii co-infection after an umbilical cord blood transplantation in a chronic myelomonocytic leukaemia patient is reported.

Case report: A 65-year-old Caucasian man underwent an umbilical cord blood transplantation within the context of chronic myelomonocytic leukaemia. On day 37 post-graft, he presented with a severe headache; PCRs of cerebrospinal fluid and blood were positive for T. gondii and HHV-6. The patient was treated with pyrimethamine and sulfadiazine associated with ganciclovir.

Conclusion: HHV-6 reactivation can trigger a reactivation of T. gondii. This case suggests that patients who are seropositive for T. gondii and who present with HHV-6 reactivation should be monitored closely for toxoplasmosis.

Keywords: Cerebral co-infection; Cord blood transplantation; Encephalitis; HHV-6; Toxoplasmosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coinfection / drug therapy
  • Coinfection / etiology
  • Coinfection / parasitology*
  • Coinfection / virology*
  • Encephalitis / drug therapy
  • Encephalitis / etiology
  • Encephalitis / parasitology*
  • Encephalitis / virology*
  • Fetal Blood / parasitology
  • Fetal Blood / virology
  • Ganciclovir / therapeutic use
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Herpesvirus 6, Human / genetics
  • Herpesvirus 6, Human / isolation & purification
  • Herpesvirus 6, Human / physiology*
  • Humans
  • Male
  • Polymerase Chain Reaction
  • Roseolovirus Infections / drug therapy
  • Roseolovirus Infections / etiology
  • Roseolovirus Infections / virology
  • Toxoplasma / genetics
  • Toxoplasma / isolation & purification
  • Toxoplasma / physiology*
  • Toxoplasmosis / drug therapy
  • Toxoplasmosis / etiology
  • Toxoplasmosis / parasitology
  • Transplant Recipients / statistics & numerical data

Substances

  • Ganciclovir