Compartmentalization of a Multidrug-Resistant Cytomegalovirus UL54 Mutant in a Stem Cell Transplant Recipient with Encephalitis

• Published in: The Journal of infectious diseases Vol. 220; no. 8; pp. 1302 - 1306
• Main Authors: Piret, Jocelyne, Schibler, Manuel, Pham, Van Dung, Hantz, Sébastien, Giannotti, Federica, Masouridi-Levrat, Stavroula, Kaiser, Laurent, Goyette, Nathalie, Alain, Sophie, Shi, Rong, Boivin, Guy
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 13.09.2019
• Subjects: Acyclovir - pharmacology; Acyclovir - therapeutic use; Antibiotic Prophylaxis - methods; Antiviral agents; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Antiviral drugs; Case reports; Cerebrospinal fluid; Cerebrospinal Fluid - virology; Cidofovir; Cytomegalovirus; Cytomegalovirus - genetics; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - cerebrospinal fluid; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - prevention & control; Cytomegalovirus Infections - virology; DNA-directed DNA polymerase; Drug resistance; Drug Resistance, Multiple, Viral - genetics; Encephalitis; Encephalitis, Viral - cerebrospinal fluid; Encephalitis, Viral - diagnosis; Encephalitis, Viral - prevention & control; Encephalitis, Viral - virology; Female; Foscarnet; Ganciclovir; Genotyping; Graft Rejection - immunology; Graft Rejection - prevention & control; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Immediate-Early Proteins - genetics; Immunosuppression - adverse effects; Life Sciences; Major and Brief Reports; Microbiology and Parasitology; Middle Aged; Multidrug resistance; Multidrug resistant organisms; Mutation; Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Stem cell transplantation; Stem cells; Viral Proteins - genetics; Virology; VIRUSES; Cytomegalovirus; three-dimensional modeling; encephalitis; compartmentalization; recombinant phenotyping; cerebrospinal fluid; hematopoietic stem cell transplantation; drug resistance; replicative capacity
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiz298

We report a case of cytomegalovirus encephalitis in a hematopoietic stem cell transplant recipient. A previously uncharacterized V787E mutation in UL54 was identified in cerebrospinal fluid but not plasma specimens. For the V787E recombinant virus, the half maximal effective concentrations for ganci...