Infection

, Volume 26, Issue 6, pp 402–404 | Cite as

Meningoencephalitis caused by human herpesvirus-6 in an immunocompetent adult patient: Case report and review of the literature

  • D. Torre
  • F. Speranza
  • R. Martegani
  • P. Ferrante
  • E. Omodeo-Zorini
  • R. Mancuso
  • G. P. Fiori
Case Report

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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    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.CrossRefPubMedGoogle Scholar
  2. 2.
    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.CrossRefPubMedGoogle Scholar
  3. 3.
    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.CrossRefGoogle Scholar
  4. 4.
    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.CrossRefGoogle Scholar
  5. 5.
    Irving, W. I., Cunningham, A. L.: Serologic diagnosis of infection with human herpesvirus type 6. Brit. Med. J. 300 (1990) 156–159.CrossRefPubMedGoogle Scholar
  6. 6.
    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.PubMedGoogle Scholar
  7. 7.
    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.CrossRefPubMedGoogle Scholar
  8. 8.
    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.CrossRefPubMedGoogle Scholar
  9. 9.
    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.CrossRefPubMedGoogle Scholar
  10. 10.
    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.PubMedGoogle Scholar
  11. 11.
    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.CrossRefPubMedGoogle Scholar
  12. 12.
    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.CrossRefPubMedGoogle Scholar
  13. 13.
    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.CrossRefPubMedGoogle Scholar
  14. 14.
    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.CrossRefGoogle Scholar
  15. 15.
    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.CrossRefPubMedGoogle Scholar
  16. 16.
    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.CrossRefPubMedGoogle Scholar
  17. 17.
    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.PubMedGoogle Scholar
  18. 18.
    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.CrossRefPubMedGoogle Scholar
  19. 19.
    Braun, D. K., Dominguez, G., Pellett, P. E.: Human herpesvirus-6. Clin. Microbiol. Rev. 10 (1997) 521–567.PubMedGoogle Scholar
  20. 20.
    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.CrossRefGoogle Scholar
  21. 21.
    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.PubMedGoogle Scholar
  22. 22.
    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.PubMedGoogle Scholar
  23. 23.
    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.PubMedGoogle Scholar
  24. 24.
    McCullers, J. A., Lakeman, F. D., Whitley, R. J.: Human herpesvirus-6 is associated with focal encephalitis. Clin. Infect. Dis. 21 (1995) 571–576.PubMedGoogle Scholar
  25. 25.
    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.CrossRefPubMedGoogle Scholar
  26. 26.
    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.PubMedGoogle Scholar
  27. 27.
    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.PubMedGoogle Scholar
  28. 28.
    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.CrossRefPubMedGoogle Scholar

Copyright information

© MMV Medien & Medizin Verlagsgesellschaft mbH, München 1998

Authors and Affiliations

  • D. Torre
    • 1
  • F. Speranza
    • 1
  • R. Martegani
    • 1
  • P. Ferrante
    • 2
  • E. Omodeo-Zorini
    • 2
  • R. Mancuso
    • 2
  • G. P. Fiori
    • 1
  1. 1.Div. of Infectious DiseasesOspedale di Circolo e Fondazione MacchiVarese
  2. 2.Laboratory of Biology, Fondazione Don GnocchiIRCCSMilanItaly

Personalised recommendations