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Meningitis caused by lymphocytic choriomeningitis virus in a patient with leukemia

Naser Al-Zein1, Thomas G Boyce, Armando G Correa

  • 1Division of Pediatric Hematology and Oncology, Mayo Clinic, Rochester, MN 55905, USA.

Journal of Pediatric Hematology/Oncology
|November 18, 2008
PubMed

Insights

A rare lymphocytic choriomeningitis virus infection caused meningitis in an immunocompromised teen with T-cell acute lymphoblastic leukemia. This viral meningitis presented with severe headache and complications like hydrocephalus.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Oncology

Background:

  • T-cell acute lymphoblastic leukemia (T-ALL) patients undergoing maintenance chemotherapy are immunocompromised.
  • Fever, neutropenia, and severe headache are common symptoms requiring differential diagnosis.

Observation:

  • A 15-year-old girl with T-ALL presented with fever, neutropenia, and severe headache during maintenance chemotherapy.
  • Cerebrospinal fluid analysis showed lymphocytic pleocytosis but no signs of leukemia relapse.

Findings:

  • Serological testing confirmed meningitis caused by lymphocytic choriomeningitis virus (LCMV).
  • The patient developed hydrocephalus, necessitating ventriculoperitoneal shunt placement, and experienced an intracranial hemorrhage.

Implications:

  • Lymphocytic choriomeningitis virus is an uncommon cause of aseptic meningitis.
  • LCMV should be considered in immunocompromised patients presenting with meningitis symptoms and a relevant exposure history.

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