Intrathecal Administration of High-Titer Cytomegalovirus Immunoglobulin for Cytomegalovirus Meningitis

Autor: Shin-ichiro Fujiwara, Kazuo Muroi, Raine Tatara, Ken Ohmine, Tomohiro Matsuyama, Masaki Mori, Tadashi Nagai, Keiya Ozawa
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Case Reports in Hematology, Vol 2014 (2014)
Druh dokumentu: article
ISSN: 2090-6560
2090-6579
DOI: 10.1155/2014/272458
Popis: Cytomegalovirus (CMV) central nervous system disease after hematopoietic stem cell transplantation (HSCT) is a rare but life-threatening complication. Here, we report a patient who developed CMV meningitis after HSCT and was treated with the combination therapy of intrathecal high-titer CMV immunoglobulin and antiviral drugs. A 38-year-old man with myelodysplastic syndrome received a cord blood transplant after graft failure. On day 147, he was diagnosed with CMV meningitis based on pleocytosis and CMV DNA in the cerebrospinal fluid (CSF). Intravenous ganciclovir, foscarnet, and immunoglobulin were administered; however, CMV DNA in the CSF was continuously detected. The addition of intrathecal high-titer CMV immunoglobulin resulted in CMV DNA in the CSF becoming undetectable. On day 241, CMV DNA in the CSF was detected again, but both intrathecal immunoglobulin and intravenous ganciclovir led to its disappearance. No adverse effects related to intrathecal administration were observed. The intrathecal administration of immunoglobulin may be safe and effective for CMV meningitis.
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