Human Astrovirus VA1 Encephalitis in Pediatric Patients With Cancer: Report of 2 Cases and Review of the Literature

Novel human astroviruses (HAstVs) have recently been implicated as rare causes of fatal encephalitis in immunocompromised patients, for which there is no proven treatment. We report 2 cases from our institution in which HAstV-VA1 was detected in the cerebrospinal fluid by metagenomic next-generation sequencing after the initial evaluation revealed no etiology. We report two children with HAstV-VA1 encephalitis detected by metagenomic next-generation sequencing. Although rare, awareness of this emerging pathogen as a cause of encephalitis in immunocompromised children is critical, given the associated poor prognosis.