[Human herpes virus type 6, etiology of an acute encephalitis in childhood: case report]

A Afenjar1, D Rodriguez, F Rozenberg

  • 1Service de Neuropédiatrie, Assistance Publique-Hôpitaux de Paris, Hôpital Armand-Trousseau, 26, avenue du Docteur-A.-Netter, 75012 Paris, France. alexandra.afenjar@trs.aphp.fr

Insights

Primary human herpesvirus-6 (HHV-6) infection can cause acute leucoencephalitis in infants, presenting with seizures and coma. Detecting HHV-6 DNA in cerebrospinal fluid confirms its role in this rare but serious neurological complication.

Area of Science:

  • Neurology
  • Virology
  • Pediatrics

Background:

  • Primary human herpesvirus-6 (HHV-6) infection typically causes roseola infantum but can lead to severe central nervous system (CNS) complications.
  • Acute leucoencephalitis is a rare but serious neurological condition in infants, often with an unclear etiology.

Observation:

  • A 16-month-old girl presented with fever, seizures, rash, and coma, indicative of acute leucoencephalitis.
  • Brain MRI revealed extensive white matter lesions.
  • Human herpesvirus-6 (HHV-6) DNA was detected in cerebrospinal fluid (CSF) and serum during the acute phase.

Findings:

  • Serological tests showed a significant increase in HHV-6 IgG antibody titers, confirming primary infection.
  • The presence of HHV-6 DNA in CSF strongly suggests the virus's etiological role in the leucoencephalitis.
  • The patient experienced complete clinical recovery with partial resolution of brain lesions on MRI within one month.

Implications:

  • This case highlights the importance of considering HHV-6 in the differential diagnosis of acute leucoencephalitis in infants.
  • Comprehensive virological investigations are crucial to identify HHV-6 and other potential pathogens (e.g., EBV, CMV, enterovirus).
  • Accurate diagnosis of HHV-6 encephalitis can prevent misattribution of symptoms to vaccinations and guide appropriate management.

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