Ere was no evidence for transplantationassociated thrombotic microangiopathy or graft-versus-host disease. Urgent computed tomography and

Ere was no evidence for transplantationassociated thrombotic microangiopathy or graft-versus-host disease. Urgent computed tomography and magnetic resonance imaginghost; Status epilepticus; Umbilical cord blood transplantationA 59-year-old man was ALDH2 Storage & Stability diagnosed with chronic lymphocytic leukemia (CLL) in 2007 and managed with different chemotherapy drugs (fludarabine, alemtuzumab, bendamustine, cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab). However, the patient needed umbilical cord blood transplantation following a lowered intensity conditioning regimen (cyclophosphamide 50 mg/kg on day -6, fludarabine 40 mg/m2 everyday from days -6 by way of -2 and total body irradiation 200 cGy on day -1) for remedy of resistant CLL in EBV Formulation February 2013. Graft-versus-host disease prophylaxis comprised sirolimus four mg every day and mycophenolate mofetil (1500 mg twice every day fromdays-3through+30).Cytomegalovirusimmunoglobulin(Ig)G and herpes simplex virus IgG had been positive, whereas Epstein-Barr virus (EBV) IgG was unfavorable. Infection prophylaxis according to internal hospital guidelines integrated levofloxacin (250 mg each day), voriconazole (200 mg twice per day for feasible invasive fungal infection because of lung nodules prior to allogeneic hematopoietic cell transplantation [alloHCT]), high-dose acyclovir (800 mg 5 instances each day), and1Division 4DepartmentCASE PRESENTATIONof Hematology-Oncology and Transplantation; 2Division of Infectious Disease, Department of Medicine; 3Department of Radiology; of Neurology, University of Minnesota, Minneapolis, Minnesota, USA; 5Department of Hematology-Oncology, Amaral Carvalho Hospital, Jau, Sao Paulo, Brazil Correspondence: Dr Celalettin Ustun, Division of Hematology Oncology and Transplantation, Department of Medicine, University of Minnesota, 14-142 PWB, 516 Delaware Street Southeast, Minneapolis, Minnesota 55455, USA. Phone 612-624-0123, fax 612-625-6919, e-mail [email protected] open-access report is distributed below the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http:// creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original operate is adequately cited and the reuse is restricted to noncommercial purposes. For commercial reuse, speak to support@pulsusCan J Infect Dis Med Microbiol Vol 25 No three May/JuneHHV6 is associated with status epilepticusA(379,300 copies/mL) on day +41. The concurrent serum sample was also positive for HHV6 (8000 copies/mL). Ganciclovir (5 mg/kg intravenous twice every day) was started as a consequence of no improvement in his clinical situation, seizure activity as well as the evolving MRI findings. Seizure activity was no longer detectable, and the patient had come to be alert and was extubated on day +43. A lengthy hospitalization ensued, which was complicated by deconditioning and various reintubations for hypercapnea and respiratory muscle weakness. He completed six weeks of ganciclovir therapy (5 mg/kg twice each day). Foscarnet was added for positive isolation of HHV6 from bronchoalveolar lavage. His cognitive function gradually enhanced with prolonged rehabilitation. He’s now at residence with residual intermittent memory loss but otherwise functional. Alteration in consciousness and seizure soon after alloHCT is often caused by posterior reversible encephalopathy syndrome, immunosuppressive drug toxicities, fludarabine toxicity, transplantation-associated thrombotic microangiopathy or central nervous sys.