INTRODUCTION
Encephalitis is characterized by brain dysfunction due to inflammation of the brain parenchyma and is associated with significant morbidity and mortality. Despite significant advances in diagnostic methods, the etiology remains unknown in about 60% of cases.1-3
Immunocompromised patients with encephalitis pose unique diagnostic and therapeutic challenges. They are more likely to have atypical presentations from common pathogens and are at higher risk of infections by novel agents.4
Classical human astroviruses (HAstV) are gastrointestinal pathogens responsible for approximately 10% cases of acute, non-bacterial gastroenteritis in children.5-7 Recently discovered, divergent strains of HAstV, MLB and VA1, also cause self-limited diarrheal illnesses.6,8 However, HAstVs have also been reported to cause fatal encephalitis, primarily in immunocompromised hosts. To date, 10 cases of HAstV central nervous system (CNS) infection have been reported.9-17 The most frequently identified strain has been VA1.9,11-14 We report 2 cases of HAsV-VA1 encephalitis in children with cancer at our institution and perform a literature review of previously published cases.