$20 International Journal o[ In[ectious Diseases (2006) IO($I ) Abstracts 25 (58%) a viral syndrome and 10 (23%) organ dis- ease. In group 2, 27 (12%) had a CMV episode, 6 (22%) viremia, 11 (41%) a viral syndrome, and 10 (37%) organ disease. Group 3 had no docu- mented CMV episodes. The average Length of hospi- talization for CMV episodes was 11 days in group I, and 2.5 days in group 2. At the end of the study 51 (74%) patients of group I had a functional graft (creatinine clearance >30mLlmin), 8 (12%) had severely impaired function (C[ <30 mLlmin), 7 (10%) were dead, and 3 (4%) had Lost their graft. The corresponding numbers for group 2 were 185 (80%), 28 (12%), 17 (8%), and for group 3 52 (81%), 4 (6%), 8 (13%), respectively. OveraLL, 25 transplanted pa- tients (6.8%) died during the observation period. Conclusions: In our experience, a preemptive treatment strategy to address the risk of CMV- related morbidity foLLowing renal transplantation was associated with a markedly higher incidence of CMV episodes in the high-risk group as compared to the intermediate-risk group. CMV episodes resulted in an average hospitalization Length of 11 days and a trend towards an increased toss of graft function was noted. Therefore and in the Light of the emer- gence of newer oral antivira[ agents with a high bioavaiLabiLity such as vaLgancicLovir, the current strategy has to be reconsidered. 36 Fatal Epstein-Barr Virus/Vleningoencephalitis in a Heart Transplant Recipient C. Garzoni*, S. Perrig, J.A. Lobrinus, B. Schnetzter, C. Van Detden. Division oJ: Infectious Disease, Geneva University Hospital, 24, rue Micheli-du- Crest, 1211 Geneva, Switzerland Background: Epstein-Barr virus (EBV) meningoen- cephatitis is a rare, normaLLy benign, complication of infectious mononucleosis. This disease might have a more severe outcome in immunosuppressed patients. Objective: We describe the case of a heart trans- plant recipient who died with presumed EBV meningoencephatitis. Results: A 68 year-oLd man was admitted, 12 years after heart transplantation for a cardiomyopathy of unknown origin, for dizziness and fatting without vertigo or other neuroLogicaL symptoms. 6 years be- fore admission he had presented several episodes of acute rejection. His immunosuppressive regi- men consisted of cyctosporine 75 mg bid and my- cophenotate mofeti[ 1250 mg bid. On admission he was afebrite and cLinicaL examination was normaL. Three days after admission he presented a somno- Lence with fever. Cerebrospina[ fluid (CSF) analysis revealed Lymphocytic meningitis with 45 [ympho- cytes/mm2 and elevated total protein LeveL. An EEG was suggestive for associated encephalitis. MRI imaging showed no abnormalities except an old is- chemic cerebeLLar Lesion. CSF cultures for bacteria (incLuding M. tuberculosis) and fungi were nega- tive. CSF analysis by PCR was positive for EBV and negative for aLLother herpes viruses (HSV-1, HSV-2, VZV, CMV, HHV-6), 3C-virus and ToxopLasmosis. EBV PCR was also positive on peripheral blood. Im- munosuppression was stopped and therapeutic i.v. gangicLovir was administered. During the foLLowing 2 weeks, partial cLinicaL response, EEG improve- ment and decrease of EBV copies, both in LCR and peripheral blood, were observed. UnfortunateLy the cLinicaL condition rapidly degraded thereafter and therapeutical retrieval was decided. He died secondarily to a bacterial pneumonia. The autopsy confirmed the presence of a T-ceLL meningitis but no other infectious agents was documented (in- cluding rabies and prion disease). At the time of au- topsy, no evidence of inflammatory infiltrates, viral RNA (LMP) or proteins (EBR) in brain parenchyma could be documented. No malignant process could be identified. Conclusion: Fatal EBV meningoencephaLitis is a very rare entity. Despite extensive search for an alternative diagnosis to explain the Lymphocytic meningoencephaLitis, we could only document a concomitant EBV replication, both in the CSF fluid and peripheral blood, in this patient. CLinicians should be aware of this possible cause of menin- goencephaLitis in immunosuppressed patients. 37 Quantification of BK Virus Load in Plasma and Urine Samples for the Diagnosis of BK Virus Associated Nephropathy in Renal Transplant Recipients D. MutLu, D. CoLak*, U. Yavuzer, M. Tuncer, S. Akman, B. Akkaya, H. Kocak, H. Demirbakan, A.G. Guven, G. KarpuzogLu, M. GuLtekin. Akdeniz University School of Medicine, 07070 Antalya, Turkey Background: In recent years an increasing number of cases with BK virus (BKV) associated nephropa- thy after renal transplantation were reported from several transplant centers. The diagnosis of BKV associated nephropathy requires invasive aLLograft biopsy sampling; therefore it is not easy to perform for aLL patients. Quantitation of BKV DNA Load in plasma or urine has a high positive predictive value for BKV associated nephropaty.