The Successful Treatment of a Cord Blood Transplant Recipient with Varicella Zoster Virus Meningitis, Radiculitis and Myelitis with Foscarnet

Intern Med. 2017;56(3):353-356. doi: 10.2169/internalmedicine.56.6930. Epub 2017 Feb 1.

Abstract

Infections of the central nervous system (CNS) with varicella zoster virus (VZV) is a rare occurrence after allogeneic hematopoietic stem cell transplantation. We herein report a case of VZV meningitis, radiculitis and myelitis that developed 8 months after cord blood transplantation, shortly after the cessation of cyclosporine and low-dose acyclovir. Although treatment with acyclovir did not achieve a satisfactory response, the patient was successfully treated with foscarnet. Our report indicates that VZV infection should be considered in allo-hematopoietic stem cell transplantation (HSCT) patients with CNS symptoms and that foscarnet may be effective for the treatment of acyclovir-resistant VZV infections of the CNS. The development of optimal prophylactic strategies and vaccination schedules may eradicate post-transplant VZV disease.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Foscarnet / therapeutic use*
  • Graft vs Host Disease / immunology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Herpes Zoster / diagnosis
  • Herpes Zoster / drug therapy
  • Herpes Zoster / etiology*
  • Herpesvirus 3, Human / isolation & purification
  • Humans
  • Meningitis, Viral / diagnosis
  • Meningitis, Viral / drug therapy
  • Meningitis, Viral / etiology*
  • Transplantation, Homologous / adverse effects

Substances

  • Antiviral Agents
  • Foscarnet
  • Acyclovir