Rare presentation of BK encephalitis in a child: imaging and pathological findings

Abstract

Clinically apparent BK virus infections mostly involve the genitourinary system of immunocompromised patients, particularly those who have undergone renal or bone marrow transplantations. Central nervous system involvement is extremely rare. In this report, we describe the pathologic and MR findings of BK encephalitis in a child. Initial involvement of the brainstem and the cervicomedullary junction was noted that later rapidly progressed to involve other regions of the supratentorial brain parenchyma including the basal ganglia and the thalami as well as the cerebellum.

Common infections with polyomaviruses and herpesviruses and neuropsychological development at 4 years of age, the Rhea birth cohort in Crete, Greece

“…Interestingly, we found that only BKPyV seropositivity was associated with more inattention symptoms suggesting virus‐specific mechanisms for this association. BKPyV is increasingly recognized as an opportunistic infectious agent of the CNS in children and adults (Green, Saigal, Rojas, & Post, ; Hirsch & Snydman, ; Lopes da Silva, ). Potentially, infiltration of the brain by BKPyV could alter or disrupt the development of neural pathways important for attention (Arnsten, ).…”

BK virus nephropathy complicated with meningoencephalitis after kidney transplantation

“…The first report of an in vivo case of BKV‐associated meningoencephalitis described a patient with AIDS who showed clinical improvement and regression of brain lesions while receiving HAART . Other cases have been reported on cardiac and bone marrow transplantation .…”

“…Green et al. presented a case of a six‐yr‐old girl with an orthotopic heart transplant since the age of three. She presented with encephalopathy, with a history of slurred speech, decreased activity, and gait abnormality and subsequently developed renal failure due to BK virus nephropathy.…”

The human polyomavirus BK (BKPyV): virological background and clinical implications

“…BKPyV DNA and/or proteins were found in CNS and in cerebrospinal fluid (CSF) and in cells in the kidneys and lungs suggesting a disseminated BKPyV disease. The last reported case was a 6-year-old child on tacrolimus treatment due to a heart transplant (105,106 …”

“…BKPyV DNA and/or proteins were found in CNS and in cerebrospinal fluid (CSF) and in cells in the kidneys and lungs suggesting a disseminated BKPyV disease. The last reported case was a 6‐year‐old child on tacrolimus treatment due to a heart transplant . She first developed PyVAN which was unsuccessfully treated with bi‐monthly intravenous cidofovir and she then developed BKPyV encephalitis which was confirmed by PCR analysis of brain parenchyma and CSF post‐mortem.…”