CHRONIC ECHO TYPE-5 VIRUS MENINGOENCEPHALITIS IN X-LINKED HYPOGAMMAGLOBULINEMIA - TREATMENT WITH IMMUNE PLASMA

A patient with X-linked hypogammaglobulinemia developed chronic meningoencephalitis. Echo virus type 5 was repeatedly cultured from CSF. Infusions of high-titer, specific plasma resulted in clinical improvement but failed to eradicate to virus. After more intensive plasma infusions, the virus could not be cultured from the CSF. The patient died 8 mo. after institution of intensive therapy. The cause of death was unknown. Autopsy showed persistence of perivascular and meningeal inflammation. Specific anti-echo-virus-5 plasma was more effective in lowering CSF echo virus titers than was plasma without anti-echovirus antibody.