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Cytomegalovirus meningitis in a patient with relapsed acute myeloid leukemia

  • Kaito Harada
  • Noritaka Sekiya
  • Shuntaro Ikegawa
  • Shugo Sasaki
  • Takeshi Kobayashi
  • Kazuteru Ohashi
Case Report
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Abstract

Cytomegalovirus meningitis/meningoencephalitis is a potentially fatal complication following hematopoietic stem cell transplantation that causes significant morbidity and mortality. In the pre-transplant setting, a few cases involving lymphoid malignancies have been reported. However, there have been no reports of patients with myeloid malignancies. A 36-year-old man with relapsed acute myeloid leukemia received high-dose cytarabine-containing salvage chemotherapies and then developed grade 4 lymphopenia for more than one month. Subsequently, the patient developed pyrexia, accompanying headache, nausea, and vomiting with no abnormal brain imaging. Despite receiving antimicrobial treatment, his febrile status and headache persisted. Given that the patient had symptoms consistent with viral meningitis with no evidence of etiology other than positive cytomegalovirus-DNA in his cerebrospinal fluid and cytomegalovirus pp65 antigenemia, cytomegalovirus meningitis was diagnosed. After commencing ganciclovir treatment, the patient’s headache and febrile status rapidly improved. Cytomegalovirus meningitis/meningoencephalitis is rare before hematopoietic stem cell transplantation, but may be useful in differential diagnoses in heavily treated acute myeloid leukemia patients with central nervous system symptoms.

Keywords

Cytomegalovirus Meningitis Hematological malignancy Acute myeloid leukemia 

Notes

Acknowledgements

The authors are grateful to the staff of the Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, for their excellent patient care.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  1. 1.Hematology DivisionTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
  2. 2.Department of Infection Prevention and Control, Department of Clinical LaboratoryTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan

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