Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia
Abstract We report the case of a girl with congenital thymic dysplasia and refractory disseminated Human Cytomegalovirus (CMV) infection diagnosed by autopsy. Additionally, she was diagnosed with T-cell lymphopenia immunodeficiency and received antiviral therapy with ganciclovir (GCV) /valganciclovi...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-11-01
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| Series: | Virology Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12985-022-01915-x |
| _version_ | 1811180289864499200 |
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| author | Yang Liu Yu Zhu Weiping Liu Chaomin Wan Qin Guo |
| author_facet | Yang Liu Yu Zhu Weiping Liu Chaomin Wan Qin Guo |
| author_sort | Yang Liu |
| collection | DOAJ |
| description | Abstract We report the case of a girl with congenital thymic dysplasia and refractory disseminated Human Cytomegalovirus (CMV) infection diagnosed by autopsy. Additionally, she was diagnosed with T-cell lymphopenia immunodeficiency and received antiviral therapy with ganciclovir (GCV) /valganciclovir (V-GCV) and enhanced foscarnet. The CMV viral load (VL) monitoring was elevated with retinitis, interstitial pneumonia, and hepatitis. The phenotype of T-cell lymphopenia was uncertain, which limited any alternative therapy by whole-exome sequencing (WES) and lymphocyte subset panel until autopsy. The girl died of progressive respiratory failure and septic shock at ten months of age. Severe disseminated CMV infection typically develops in infants with primary maternal infections and occurs earlier during gestation and in people with a weakened host immune system. Individuals with CMV infection with initial immunodeficiency are associated with a poor prognosis, which is similar to patients with secondary immunodeficiency. This case describes the difficult treatment and prognosis of CMV infection in patients with congenital immunodeficiency, highlighting the importance of early aggressive anti-CMV antiviral therapy in immunodeficiencies, VL monitoring, drug resistance and the role of T-cells in CMV infection. |
| first_indexed | 2024-04-11T06:49:04Z |
| format | Article |
| id | doaj.art-4011300d17394587b8418e3dd414e813 |
| institution | Directory Open Access Journal |
| issn | 1743-422X |
| language | English |
| last_indexed | 2024-04-11T06:49:04Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj.art-4011300d17394587b8418e3dd414e8132022-12-22T04:39:17ZengBMCVirology Journal1743-422X2022-11-011911810.1186/s12985-022-01915-xDeath from human cytomegalovirus infection in a girl with congenital thymic dysplasiaYang Liu0Yu Zhu1Weiping Liu2Chaomin Wan3Qin Guo4Department of Pediatrics, West China Second Hospital, Sichuan UniversityDepartment of Pediatrics, West China Second Hospital, Sichuan UniversityDepartment of Pathology, West China HospitalDepartment of Pediatrics, West China Second Hospital, Sichuan UniversityDepartment of Pediatrics, West China Second Hospital, Sichuan UniversityAbstract We report the case of a girl with congenital thymic dysplasia and refractory disseminated Human Cytomegalovirus (CMV) infection diagnosed by autopsy. Additionally, she was diagnosed with T-cell lymphopenia immunodeficiency and received antiviral therapy with ganciclovir (GCV) /valganciclovir (V-GCV) and enhanced foscarnet. The CMV viral load (VL) monitoring was elevated with retinitis, interstitial pneumonia, and hepatitis. The phenotype of T-cell lymphopenia was uncertain, which limited any alternative therapy by whole-exome sequencing (WES) and lymphocyte subset panel until autopsy. The girl died of progressive respiratory failure and septic shock at ten months of age. Severe disseminated CMV infection typically develops in infants with primary maternal infections and occurs earlier during gestation and in people with a weakened host immune system. Individuals with CMV infection with initial immunodeficiency are associated with a poor prognosis, which is similar to patients with secondary immunodeficiency. This case describes the difficult treatment and prognosis of CMV infection in patients with congenital immunodeficiency, highlighting the importance of early aggressive anti-CMV antiviral therapy in immunodeficiencies, VL monitoring, drug resistance and the role of T-cells in CMV infection.https://doi.org/10.1186/s12985-022-01915-xCongenital thymic dysplasiaCytomegalovirusRefractoryResistance |
| spellingShingle | Yang Liu Yu Zhu Weiping Liu Chaomin Wan Qin Guo Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia Virology Journal Congenital thymic dysplasia Cytomegalovirus Refractory Resistance |
| title | Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia |
| title_full | Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia |
| title_fullStr | Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia |
| title_full_unstemmed | Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia |
| title_short | Death from human cytomegalovirus infection in a girl with congenital thymic dysplasia |
| title_sort | death from human cytomegalovirus infection in a girl with congenital thymic dysplasia |
| topic | Congenital thymic dysplasia Cytomegalovirus Refractory Resistance |
| url | https://doi.org/10.1186/s12985-022-01915-x |
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