Herpes simplex encephalitis and subsequent cytomegalovirus encephalitis after chemoradiotherapy for central nervous system lymphoma: a case report and literature review

Int J Hematol. 2008 Jun;87(5):538-541. doi: 10.1007/s12185-008-0083-6. Epub 2008 Apr 17.

Abstract

Neurological complications during the treatment of hematological malignancies have a wide range of causes. Treatment-related leukoencephalopathy has been recognized as a major complication of combined chemotherapy and radiotherapy for central nervous system (CNS) lymphoma, and can complicate the diagnosis of CNS infection. Herein, we present a patient with diffuse large B-cell lymphoma who developed herpes simplex encephalitis (HSE) and subsequent cytomegalovirus encephalitis after chemoradiotherapy for CNS relapse. Although cerebrospinal fluid examination (CSF) showed no significant pleocytosis, brain magnetic resonance imaging and polymerase chain reaction analysis of the CSF were useful in the diagnosis. With a review of the literature on the association between HSE and radiotherapy for CNS malignancies, our case suggests that an awareness of viral encephalitis is important in the differential diagnosis of acute neurologic disturbance during chemoradiotherapy for CNS lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Asian People
  • Central Nervous System Neoplasms / complications*
  • Central Nervous System Neoplasms / diagnosis
  • Central Nervous System Neoplasms / therapy
  • Combined Modality Therapy / adverse effects
  • Cytomegalovirus Infections / etiology*
  • Diagnosis, Differential
  • Encephalitis, Viral / diagnosis
  • Encephalitis, Viral / etiology*
  • Female
  • Herpes Simplex / diagnosis
  • Herpes Simplex / etiology*
  • Humans
  • Japan
  • Lymphoma, Large B-Cell, Diffuse / complications*
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / therapy