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Dengue encephalitis in allogenic hematopoietic stem cell transplantation recipient

Bone Marrow Transplantation volume 52, pages 1455–1456 (2017)Cite this article

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An altered mental state with or without neurologic signs have become more frequent in patients after hematopoietic stem cell transplantation (HSCT).1 The neurologic problems are different according to the stage of transplant. In the pre-engraftment period, the occurrence is associated with toxicity of high-dose chemotherapy, bacterial infections, intracranial bleeding and other drug-related neurotoxicity. During the late post-transplant phase, with the use of immunosuppressive drugs and the occurrence of GvHD, the following neurologic complications can occur: central nervous system (CNS) infections, cerebrovascular disease, metabolic encephalopathy, calcineurin inhibitor neurotoxicity with thrombotic microangiopathy or posterior reversible encephalopathy syndrome and immune-mediate disorders.

In a retrospective analysis, CNS infection accounts for only 9% of CNS complications after HSCT.2 In suspected CNS infection, it is important to perform the appropriate diagnostic procedures, which include an initial neuroimaging with MRI or CT scan and subsequent cerebrospinal fluid (CSF) examination.3 The most prevalent etiologies are cerebral toxoplasmosis followed by aspergillosis.4 Viral CNS infection after HSCT is uncommon. Herein we report the first case of dengue encephalitis in an allogenic HSCT patient.

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References

  1. Maffini E, Festuccia M, Brunello L, Boccadoro M, Giaccone L, Bruno B . Neurologic complications after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2017; 23: 388–397.

    Article  PubMed  Google Scholar 

  2. Bhatt VR, Balasetti V, Jasem JA, Giri S, Armitage JO, Loberiza FR Jr et al. Central nervous system complications and outcomes after allogeneic hematopoietic stem cell transplantation. Clin Lymphoma Myeloma Leuk 2015; 15: 606–611.

    Article  PubMed  Google Scholar 

  3. Schmidt-Hieber M, Silling G, Schalk E, Heinz W, Panse J, Penack O et al. CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Oncol 2016; 27: 1207–1225.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Maschke M, Dietrich U, Prumbaum M, Kastrup O, Turowski B, Schaefer UW et al. Opportunistic CNS infection after bone marrow transplantation. Bone Marrow Transplant. 1999; 23: 1167–1176.

    Article  CAS  PubMed  Google Scholar 

  5. Assenza F, Tombini M, Assenza G, Campana C, Benvenga A, Brunelli N et al. Dengue encephalitis presenting with nonconvulsive status epilepticus: a case report. Clin Neurol Neurosurg 2016; 150: 89–91.

    Article  CAS  PubMed  Google Scholar 

  6. Carod-Artal FJ, Wichmann O, Farrar J, Gascón J . Neurological complications of dengue virus infection. Lancet Neurol 2013; 12: 906–919.

    Article  PubMed  Google Scholar 

  7. Machado CM, Pereira BBS, Felix AC, Oliveira MC, Darrigo LG Jr, Souza MP et al. Zika and chikungunya virus infections in hematopoietic stem cell transplant recipients and oncohematological patients. Blood Adv 2017; 1: 624–627.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Hematology Division, Walter Cantidio University Hospital, Federal University of Ceara, Fortaleza, Brazil

    K S N Barroso, J Kaufman, D M Brunetta & F Barroso-Duarte

  2. HEMOCE–Haematology and Hemotherapy Center of Ceara, Fortaleza, Brazil

    K S N Barroso, J Kaufman, D M Brunetta & F Barroso-Duarte

  3. LACEN–Central Laboratory of Ceara, Fortaleza, Brazil

    F M de Carvalho Araújo

Authors
  1. K S N Barroso
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  2. J Kaufman
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  3. D M Brunetta
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  4. F M de Carvalho Araújo
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  5. F Barroso-Duarte
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Correspondence to K S N Barroso.

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Barroso, K., Kaufman, J., Brunetta, D. et al. Dengue encephalitis in allogenic hematopoietic stem cell transplantation recipient. Bone Marrow Transplant 52, 1455–1456 (2017). https://doi.org/10.1038/bmt.2017.152

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