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首页> 外文期刊>Infection and Drug Resistance >Human herpesvirus-6 pneumonitis in a patient with follicular lymphoma following immunochemotherapy with rituximab
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Human herpesvirus-6 pneumonitis in a patient with follicular lymphoma following immunochemotherapy with rituximab

机译：利妥昔单抗免疫化疗后滤泡性淋巴瘤患者的人类疱疹病毒6型肺炎

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Primary infection with human herpesvirus-6 (HHV-6) commonly occurs at an early age in children, most often at 3 years of age, and is associated with childhood diseases, such?as exanthema subitum, hepatitis, febrile convulsions, or encephalitis. However, the virus occasionally reactivates from its latent state in immunosuppressed adults, especially posttransplant, resulting in serious disseminated, sometimes life-threatening end-organ complications. Herein, we report a case of a 68-year-old man with relapsed follicular lymphoma who developed HHV-6 pneumonitis. Eighteen months after achieving second complete remission by salvage immunochemotherapy with rituximab, the patient was complicated by pneumonia, with chest computed tomography finding showing disseminated nodular shadows with ground-glass opacity in both lungs. While empiric antibiotic and antifungal therapies did not improve the pneumonia, polymerase chain reaction–based viral screening tests on his bronchoalveolar lavage fluid detected the presence of HHV-6 DNA, and ganciclovir treatment quickly resolved the pneumonia, indicating that he suffered from HHV-6 pneumonitis. He had no other HHV-6–related end-organ damage, such as encephalitis. This case suggests that, although extremely rare, HHV-6 reactivation should be considered as one of the candidate pathogens for pulmonary complications of uncertain etiology in patients who have been treated with intensive immunosuppressive chemotherapy, even without hematopoietic stem cell transplantation. Furthermore, polymerase chain reaction–based viral screening testing on bronchoalveolar lavage fluid is a powerful diagnostic tool for pneumonitis due to viral reactivation, including HHV-6 reactivation.
机译：人疱疹病毒6（HHV-6）的原发感染通常发生在儿童的早期，最常见的是3岁，并且与儿童疾病有关，例如皮下皮炎，肝炎，高热惊厥或脑炎。但是，在受免疫抑制的成年人中，尤其是移植后，病毒有时会从其潜伏状态重新激活，从而导致严重的扩散性，有时甚至危及生命的终末器官并发症。在此，我们报道了一名68岁的复发性滤泡性淋巴瘤患者，该患者发展为HHV-6肺炎。在通过利妥昔单抗挽救性免疫化学疗法实现第二次完全缓解后的18个月，该患者并发肺炎，胸部X线体层摄影术发现双肺弥散性结节性阴影伴有毛玻璃样混浊。尽管经验性抗生素和抗真菌疗法并未改善肺炎，但对他的支气管肺泡灌洗液进行的基于聚合酶链反应的病毒筛查测试发现了HHV-6 DNA的存在，更昔洛韦治疗迅速解决了肺炎，表明他患有HHV-6肺炎。他没有其他与HHV-6相关的终末器官损害，例如脑炎。该病例表明，尽管接受了强化免疫抑制化学疗法（即使未造血干细胞移植）的患者，HHV-6的再激活尽管极为罕见，但应被视为病因不明的肺部并发症的候选病原体之一。此外，对基于支气管肺泡灌洗液的聚合酶链反应进行的病毒筛查测试是一种针对病毒性激活（包括HHV-6激活）的肺炎的强大诊断工具。

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