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 diagnosed with chronic lymphocytic leukemia (CLL) in 2007 and managed with a variety of chemotherapy drugs (fludarabine, alemtuzumab, bendamustine, cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab). However, the patient needed umbilical cord blood transplantation following a decreased intensity conditioning regimen (cyclophosphamide 50 mg/kg on day -6, fludarabine 40 mg/m2 everyday from days -6 through -2 and total body irradiation 200 cGy on day -1) for remedy of resistant CLL in February 2013. Graft-versus-host illness prophylaxis comprised sirolimus 4 mg everyday and mycophenolate mofetil (1500 mg twice every day fromdays-3through+30).Cytomegalovirusimmunoglobulin(Ig)G and herpes simplex virus IgG were optimistic, whereas Epstein-Barr virus (EBV) IgG was unfavorable. Infection prophylaxis determined by internal hospital guidelines integrated levofloxacin (250 mg daily), voriconazole (200 mg twice per day for feasible invasive fungal infection on account of lung nodules before allogeneic hematopoietic cell transplantation [alloHCT]), high-dose acyclovir (800 mg 5 occasions each day), and1Division 4DepartmentCASE PRESENTATIONof Hematology-Oncology and Transplantation; 2Division of Oxazolidinone manufacturer Infectious Illness, Division 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, Division of Medicine, University of Minnesota, 14-142 PWB, 516 Delaware Street Southeast, Minneapolis, Minnesota 55455, USA. Telephone 612-624-0123, fax 612-625-6919, e-mail [email protected] open-access write-up is distributed below the terms on the Inventive Commons Attribution Non-Commercial License (CC BY-NC) (http:// creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction from the article, offered that the original perform is correctly cited as well as the reuse is restricted to noncommercial purposes. For industrial reuse, contact support@pulsusCan J Infect Dis Med Microbiol Vol 25 No three May/JuneHHV6 is related with status epilepticusA(379,300 copies/mL) on day +41. The concurrent serum sample was also good for HHV6 (8000 copies/mL). Ganciclovir (5 mg/kg intravenous twice per day) was started due to no improvement in his clinical condition, seizure activity and also the evolving MRI findings. Seizure activity was no longer detectable, along with the patient had turn out to be alert and was extubated on day +43. A long hospitalization ensued, which was complex by deconditioning and LTB4 Storage & Stability numerous reintubations for hypercapnea and respiratory muscle weakness. He completed six weeks of ganciclovir therapy (5 mg/kg twice per day). Foscarnet was added for optimistic 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 following alloHCT might be brought on by posterior reversible encephalopathy syndrome, immunosuppressive drug toxicities, fludarabine toxicity, transplantation-associated thrombotic microangiopathy or central nervous sys.