Emergence and Compartmentalization of Fatal Multi-Drug-Resistant Cytomegalovirus Infection in a Patient With Autosomal-Recessive Severe Combined Immune Deficiency
- 1 September 2004
- journal article
- case report
- Published by Wolters Kluwer Health in Journal of Pediatric Hematology/Oncology
- Vol. 26 (9) , 601-605
- https://doi.org/10.1097/01.mph.0000135283.77668.6a
Abstract
The authors describe a patient with autosomal-recessive severe combined immunodeficiency (SCID) with severe, multiorgan cytomegalovirus (CMV) disease. In the face of appropriate therapy, the patient developed a 100-fold gradient in viral load across the blood–brain barrier. Disseminated disease, including pneumonitis, contributed to a fatal outcome. Serial genotypic analyses revealed multiple UL97 and UL54 (DNA polymerase) mutations that conferred phenotypic resistance to all currently licensed systemic CMV antivirals.Keywords
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