An emerging opportunistic infection: fatal astrovirus (VA1/HMO-C) encephalitis in a pediatric stem cell transplant recipient

Su Han Lum; Andrew Turner; Malcolm Guiver; Denise Bonney; Timorthy Martland; Emma Davies; Melanie Newbould; Julianne Brown; Sofia Morfopoulou; Judith Breuer; Robert Wynn

doi:10.1111/tid.12607

An emerging opportunistic infection: fatal astrovirus (VA1/HMO-C) encephalitis in a pediatric stem cell transplant recipient

Transpl Infect Dis. 2016 Dec;18(6):960-964. doi: 10.1111/tid.12607. Epub 2016 Oct 27.

Authors

Affiliations

¹ Department of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester, UK.
² Clinical Virology Department, Manchester Royal Infirmary, Manchester, UK.
³ Department of Neurology, Royal Manchester Children's Hospital, Manchester, UK.
⁴ Diagnostic Paediatric Histopathology Service, Royal Manchester Children's Hospital, Manchester, UK.
⁵ Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children, London, UK.
⁶ Research Department of Infection, Division of Infection and Immunity, University College of London, London, UK.

PMID: 27632248
DOI: 10.1111/tid.12607

Abstract

Neuroinvasive astrovirus (VA1-HMO-C) is an emerging life-threatening infection in immunocompromised hosts. We describe an 8-month-old child who died of VA1/HMO-C encephalitis following bone marrow transplantation. The diagnosis was only made post-mortem using RNA deep sequencing of the brain. Repeat analysis of the post-mortem brain tissue using polymerase chain reaction specific primers for VA1/HMO-C was positive. Astrovirus VA1/HMO-C should be included in the evaluation of patients with similar encephalitis.

Keywords: BMT; astrovirus VA1-HMO-C; deep brain sequencing; unexplained encephalitis.

Publication types

Case Reports

MeSH terms

Astroviridae Infections / virology*
Biopsy
Bone Marrow Transplantation / adverse effects*
Brain / diagnostic imaging
Brain / pathology
Chromosomes, Human, Pair 10 / genetics
Chromosomes, Human, Pair 11 / genetics
Diarrhea / etiology
Encephalitis, Viral / cerebrospinal fluid
Encephalitis, Viral / diagnostic imaging
Encephalitis, Viral / pathology
Encephalitis, Viral / virology*
Enteritis / complications
Enteritis / virology
Fatal Outcome
Feces / virology
Female
Graft vs Host Disease / drug therapy
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Immunocompromised Host
Immunosuppressive Agents / administration & dosage
Immunosuppressive Agents / adverse effects*
Immunosuppressive Agents / therapeutic use
Infant
Leukemia, Myeloid, Acute / drug therapy
Leukemia, Myeloid, Acute / genetics
Leukemia, Myeloid, Acute / surgery*
Magnetic Resonance Imaging
Mamastrovirus / isolation & purification*
Opportunistic Infections / virology*
RNA, Viral / isolation & purification
Sequence Analysis, RNA
Translocation, Genetic
Transplantation Conditioning / adverse effects*

Substances

Immunosuppressive Agents
RNA, Viral

Associated data

GENBANK/KJ920196