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Washington University Experience | INFECTION | Viruses | Adenovirus Encephalitis | 1A0 Case 1 History

1A0 Case 1 History
Case 1 History ---- The current case involves a 38-year-old woman with a 4 month history of medulloblastoma of the cerebellum treated with surgery and radiation. She was admitted to the neurology service with a 24 hour history of worsening confusion, problems with speech and balance and fever. She had just completed her fifth round of total central nervous system irradiation 4 days prior to admission. The patient was placed on empiric broad-spectrum antimicrobials for presumptive encephalitis (acyclovir, vancomycin, and cefepime), and her maintenance dose of dexamethasone was increased because of concern for radiation induced cerebral edema. She was biopsied and shown to have meningoencephalitis, the agent subsequently shown to be Adenovirus serotype 26. The patient’s neurological status declined rapidly. Her neurological function, including brain stem reflexes, continued to deteriorate and the patient expired on hospital day 24. PCR and immunohistochemistry demonstrated adenovirus serotype 26. (Published J Neurovirol (2006) 12(3):235-40).



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