Summary
Human herpesvirus-6 (HHV-6) is the etiologic agent of roseola infantum, and has been implicated as a possible cause of encephalitis in pediatric and adult patients. A case of meningoencephalitis in an otherwise healthy, immunocompetent 59-year-old woman is described. The diagnosis of HHV-6 meningoencephalitis was confirmed by detecting viral DNA in cerebrospinal fluid collected in the acute stage of the disease by polymerase chain reaction. The patient was treated with acyclovir and recovered without any sequelae. The current knowledge of the pathophysiology, clinical course and outcome of HHV-6 meningoencephalitis in immunocompetent adult patients is also reviewed.
Similar content being viewed by others
References
Salahuddin, S. Z., Ablashi, D. V., Markham, P. D., Josephs, S. F., Sturzenegger, S., Kaplan, M., Halligan, G., Biberfeld, P., Wong-Staal, F., Kramarsky, B., Galio, R. C.: Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science 234 (1986) 596–601.
Schirmer, E. C., Wyatt, L. S., Yamanishi, K., Rodriguez, W. J., Frenkel, N.: Differentiation between two distinct classes of viruses now classified as human herpesvirus-6. Proc. Natl. Acad. Sci. USA 88 (1991) 5922–5926.
Yamanishi, K., Okuno, T., Shiraki, K., Takahashi, M., Kondo, T., Asano, Y., Kurata, T. L.: Identification of human herpesvirus-6 as a causal agent for exanthum subitum. Lancet i (1988) 1065.
Pruksananhonda, P., Hall, C. B., Insel, R. A., McIntyre, K., Pellett, P. E., Long, C. E., Schnabel, K. C., Pincus, P. H., Stamey, F. R., Dambaugh, T. R., Stewart, J. A.: Primary human herpesvirus-6 infection in young children. N. Engl. J. Med. 326 (1992) 1445–1450.
Irving, W. I., Cunningham, A. L.: Serologic diagnosis of infection with human herpesvirus type 6. Brit. Med. J. 300 (1990) 156–159.
Russler, S. K., Tapper, M. A., Knox, K. K., Liepius, A., Carrigan, D. R.: Pneumonitis associated wit coinfection by human herpesvirus-6 andLegionella in an immunocompetent adult. Am. J. Pathol. 138 (1991) 1405–1411.
Sobue, R., Miyazki, H., Okamoto, M., Hirano, M., Yoshikawa, T., Suga, S., Asano, Y.: Fulminant hepatitis in primary human herpesvirus-6 infection. N. Engl. J. Med. 324 (1991) 1290.
Huang, L. M., Lee, C. Y., Lee, P. I., Chen, J. M., Wang, P. J.: Meningitis caused by human herpesvirus-6. Arch. Dis. Child. 66 (1991) 1443–1444.
Ishiguro, N., Yamada, S., Takahashi, T., Takahashi, Y., Togashi, T., Okuno, T., Yamanishi, K.: Meningoencephalitis associated with HHV-6 related exanthem subitum. Acta Paediatr. Scand. 79 (1990) 987–989.
Yoshikawa, T., Nakashima, T., Suga, S., Hirano, M., Asano, Y.: Human herpesvirus-6 DNA in cerebrospinal fluid of a child with exanthem subitum and meningoencephalitis. Pediatrics 89 (1992) 888–890.
Irving, W. L., Chang, J., Raymond, D. R., Dunstan, R., Grattan-Smith, P., Cunningham, A. L.: Roseola infantum and other syndromes associated with HHV-6 infection. Arch. Dis. Child. 65 (1990) 1297–1300.
Wagner, M., Mueller-Berghans, J., Schroeder, R., Sollberg, S.: Human herpesvirus-6 (HHV-6)-associated necrotizing encephalitis in Griscelli's syndrome. J. Med. Virol. 53 (1997) 306.
Kimberlin, D. W.: Human herpesvirus 6 and 7: identification of newly recognized viral pathogens and their association with human disease. Pediatr. Infect. Dis. J. 17 (1998) 59–68.
Drobysky, W. R., Knox, K. K., Majewski, D., Carrigan, D. R.: Brief report: fatal encephalitis due to variant B human herpesvirus-6 infection in a bone marrow transplant recipient. N. Engl. J. Med. 330 (1994) 1356–1360.
Wilborn, F., Schmidt, C. A., Brinkmann, V., Jendroska, K., Oettle, H., Siegert, W.: A potential role for human herpesvirus type 6 in nervous system disease. J. Neuroimmunol. 49 (1994) 213–214.
Saito, Y., Sharer, L. R., Dewhurst, S., Blumberg, B. M., Hall, C. B., Epstein, L. G.: Cellular localization of human herpesvirus-6 in the brain of children with AIDS encephalopathy. J. Neurovirol. 1 (1995) 30–39.
Knox, K. K., Carrigan, D. R.: Active human herpesvirus (HHV-6) infection of the central nervous system in patients with AIDS. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 9 (1995) 69–73.
Luppi, M., Barozzi, P., Maiorana, A., Collina, G., Ferrari, M. G., Marasca, R., Morselli, M., Rossi, E., Ceccherini-Nelli, L., Torelli, G.: Human herpesvirus-6: a survey of presence and distribution of genomic sequences in normal brain and neuroglial tumors. J. Med. Virol. 47 (1995) 105–111.
Braun, D. K., Dominguez, G., Pellett, P. E.: Human herpesvirus-6. Clin. Microbiol. Rev. 10 (1997) 521–567.
Ferrante, P., Omodeo-Zorini, E., Zuffolato, M. R., Mancuso, R., Caldarelli-Stefano, R., Puricelli, S., Mediati, M., Losciale, L., Caputo, D.: Human T cell lymphotropic virus tax and Epstein-Barr virus DNA in peripheral blood of multiple sclerosis patients during acute attack. Acta Neurol. Scand. (Suppl.) 169 (1997) 79–85.
Secchiero, P., Carrigan, D. R., Asano, Y., Benedetti, L., Crowley, R. W., Komaroff, A. L., Gallo, R. C., Lusso, P.: Detection of human herpesvirus-6 in plasma of children with primary infection and immuno-suppressed patients by polymerase chain reaction. J. Infect. Dis. 171 (1995) 273–280.
Caserta, M. T., Hall, C. B., Schnabel, K., McIntyre, K., Long, G., Costanzo, M., Dewhurst, S., Insel, R., Epstein, L. G.: Neuroinvasion and persistence of human herpesvirus-6 in children. J. Infect. Dis. 170 (1994) 1586–1589.
Patnaik, M., Pater, J. B.: Intrathecal synthesis of antibodies to human herpesvirus-6 early antigen in patients with meningoencephalitis. Clin. Infect. Dis. 21 (1995) 715–716.
McCullers, J. A., Lakeman, F. D., Whitley, R. J.: Human herpesvirus-6 is associated with focal encephalitis. Clin. Infect. Dis. 21 (1995) 571–576.
Levy, J. A., Ferro, F., Greenspan, D., Lennette, E. T.: Frequent isolation of HHV-6 from saliva and high seroprevalence of the virus in the population. Lancet 335 (1990) 1047–1050.
Luppi, M., Barozzi, P., Maiorana, A., Marasca, R., Torelli, G.: Human herpesvirus-6 infection in normal human brain tissue. J. Infect. Dis. 169 (1994) 943–944.
Agut, H., Aubin, J. T., Huraux, J. M.: Homogeneous susceptibility of distinct human herpesvirus-6 strains to antiviralsin vitro. J. Infect. Dis. 163 (1991) 1382–1383.
Agut, H., Collandre, H., Aubin, J. T., Guetard, D., Favier, V., Ingrand, D., Montagner, L., Huraux, J. M.:In vitro sensitivity of human herpesvirus-6 to antiviral drugs. Res. Virol. 140 (1989) 219–228.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Torre, D., Speranza, F., Martegani, R. et al. Meningoencephalitis caused by human herpesvirus-6 in an immunocompetent adult patient: Case report and review of the literature. Infection 26, 402–404 (1998). https://doi.org/10.1007/BF02770845
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02770845