Key result
Human astrovirus VA1 was identified by metagenomics next-generation sequencing in the cerebrospinal fluid of two pediatric cancer patients with encephalitis, resulting in one death and one survival.
Why the study?
Novel human astrovirus strains have recently been shown to cause fatal encephalitis in immunocompromised patients.
Case Report (n=2)
No
Metagenomics next generation sequencing is a valuable tool for identifying human astrovirus VA1 as a cause of encephalitis in immunocompromised pediatric cancer patients when initial evaluation is unrevealing.
VA1 astrovirus merits consideration in unexplained encephalitis among pediatric cancer patients; extends known neurotropism but leaves incidence and management open.
Novel human astrovirus (HAstV) strains have been recently shown to cause fatal encephalitis in immunocompromised patients. We report two cases from our institution. A 2-year old female undergoing treatment for acute lymphoblastic leukemia and a 9-year old male with refractory acute myeloid leukemia. Both were found to have HAstV-VA1 in the cerebrospinal fluid (CSF) by metagenomics next generation sequencing (m-NGS) after the initial evaluation did not reveal any etiology. Patient 1 remains alive, in remission, showing gradual neurological improvement after treatment with steroids, intravenous immunoglobulin, ribavirin, nitazoxanide and Peg-INF-alpha 2b. Patient 2 died 7 weeks later while receiving palliative care.
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Bami et al. (2024) conducted a case report in Human astrovirus VA1 encephalitis in pediatric cancer (n=2). Human astrovirus VA1 infection was evaluated on Clinical outcome. Human astrovirus VA1 was identified by metagenomics next-generation sequencing in the cerebrospinal fluid of two pediatric cancer patients with encephalitis, resulting in one death and one survival.
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