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Infection

, Volume 45, Issue 3, pp 385–388 | Cite as

Acute human herpes virus 7 (HHV-7) encephalitis in an immunocompetent adult patient: a case report and review of literature

  • Nicoletta RivaEmail author
  • Iacopo Franconi
  • Marianna Meschiari
  • Erica Franceschini
  • Cinzia Puzzolante
  • Gianluca Cuomo
  • Alessandro Bianchi
  • Francesca Cavalleri
  • Maurilio Genovese
  • Cristina Mussini
Case Report

Abstract

We report a case of an acute HHV-7 encephalitis involving the nucleus of the VI cranial nerve in an immunocompetent host. The patient was an adult male admitted to our Clinic with headache, diplopia, fever, nausea, vertigo, asthenia and general malaise. PCR for viral and bacterial genomes was run on both serum and cerebral spinal fluid (CSF) after performing lumbar puncture, resulting positive only for HHV-7 DNA on CSF. MRI showed hyperintensity in FLAIR signal in the dorsal pons, in the area of the VI cranial nerve nucleus. Empirical therapy with Acyclovir and Dexamethasone was started at the time of admission and was continued after the microbiology results. After three days of therapy diplopia, fever and other previous clinical manifestations improved and the patient recovered normal sight. Our case report contributes to a better understanding of the presentation, diagnosis and treatment of HHV-7 encephalitis in immunocompetent patients due to reactivation in adult age.

Keywords

HHV-7 Encephalitis Immunocompetent host Diplopia 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Wyatt LS, Frenkel N. Human herpesvirus 7 is a constitutive inhabitant of adult human saliva. J Virol. 1992;66:3206–9.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Smith C, Khanna R, et al. Immune regulation of human herpesviruses and its implications for human transplantation American. J Transplant. 2013;13:9–23.CrossRefGoogle Scholar
  3. 3.
    Frenkel N, Schirmer EC, Wyatts LS, et al. Isolation of a new herpesvirus from human CD4+ T cells. Proc Natl Acad Sci USA. 1990;87:748–52.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Ward KN, Kalima P, MacLeod KM, et al. Neuroinvasion during delayed primary HHV-7 infection in an immunocompetent adult with encephalitis and flaccid paralysis. J Med Virol. 2002;67:538–41.CrossRefPubMedGoogle Scholar
  5. 5.
    Ls Wyatt, Rodriguez WJ, Balachandran N, et al. Human herpesvirus 7: antigenic properties and prevalence in children and adults. J Virol. 1991;65:6260–5.Google Scholar
  6. 6.
    Ward KN. The natural history and laboratory diagnosis of human herpesviruses-6 and -7 infections in the immunocompetent. J Clin Virol. 2005;32:183–93.CrossRefPubMedGoogle Scholar
  7. 7.
    Fule Robles JD, et al. Human herpesvirus types 6 and 7 infection in pediatric hematopoietic stem cell transplant recipients. Ann Transplant. 2014;19:269–76.CrossRefPubMedGoogle Scholar
  8. 8.
    Chan PKS, Ng HK, et al. Prevalnece and distribution of human herpesvirus 7 in normal brain. J Med Virol. 2000;62:345–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Leveque N, Van Haecke A, Renois F, Boutolleau D, Talmud D, Andreoletti L. Rapid virological diagnosis of central nervous system infections by use of a multiplex reverse transcription-PCR DNA microarray. J Clin Microbiol. 2011;49:3874–9.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Yoshikawa T, Ihira M, Suzuki K, et al. Invasion by human herpesvirus 6 and human herpesvirus 7 of the central nervous system in patients with neurological signs and symptoms. Arch Dis Child. 2000;83:170–1.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Torigoe S, Koide W, Yamada M, Miyashiro E, Taya KT, et al. Human herpesvirus 7 infection associated with central nervous system manifestations. J Pediatr. 1996;129:301–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Escobar-Villalba A, et al. Acute myelitis by human herpes virus 7 in an HIV-infected patient. J Clin Virol. 2016;77:63–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Ginanneschi F, Donati D, Moschettini D, et al. Encephaloradiculomyelitis associated to HHV-7 and CMV co-infection in immunocompetent host. Clin Neurol Neurosurg. 2007;109:272–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Ward KN, Andrews NJ, Verity CM, Miller E, Ross EM, et al. Humanherpesviruses-6 and -7 each cause significant neurological morbidity in Britain and Ireland. Arch Dis Child. 2005;90:619–23.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Zhang Y, Schols D, De Clercq E, et al. Selective activity of various antiviralcompounds against HHV-7 infection. Antivir. Res. 1999;43:23–35.CrossRefPubMedGoogle Scholar
  16. 16.
    Schwartz KL, Richardson SE, Ward KN, Donaldson C, MacGregor D, Banwell B, Mahant S, Bitnun A. Delayed primary HHV-7 Infection and neurologic disease. Pediatrics. 2014;13:1541–7.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Nicoletta Riva
    • 1
    Email author
  • Iacopo Franconi
    • 1
  • Marianna Meschiari
    • 1
  • Erica Franceschini
    • 1
  • Cinzia Puzzolante
    • 1
  • Gianluca Cuomo
    • 1
  • Alessandro Bianchi
    • 1
  • Francesca Cavalleri
    • 2
  • Maurilio Genovese
    • 2
  • Cristina Mussini
    • 1
  1. 1.Department of Infectious DiseasesUniversity of Modena and Reggio EmiliaModenaItaly
  2. 2.Neuroradiology Unit, Department of NeuroscienceNuovo Ospedale Civile S. Agostino Estense di Modena, Azienda Unità Sanitaria Locale di ModenaModenaItaly

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