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Pediatric Hemorrhagic Brainstem Encephalitis Associated With HHV-7 Infection.
Alex J Fay1, Michael J Noetzel1, Soe S Mar1
1Department of Pediatric Neurology, Washington University, St. Louis, Missouri.
Pediatric Neurology
|August 11, 2015
Summary
Human herpesvirus-7 (HHV-7) caused severe brainstem encephalitis in a previously healthy child. Prompt treatment with immunotherapy led to recovery, suggesting early intervention is key for this rare condition.
Area of Science:
- Neurology
- Virology
- Immunology
Background:
- Human herpesviruses-6 and -7 (HHV-6, HHV-7) are linked to febrile seizures and encephalitis, particularly in immunocompromised patients.
- Acute hemorrhagic encephalitis, often fatal, can be triggered by viral infections or occur post-infection, with causes sometimes unidentified.
- HHV-7 associated hemorrhagic encephalitis is rare, with only one prior case reported in an immunocompromised child.
Observation:
- An 11-year-old boy presented with hemorrhagic brainstem encephalitis.
- Extensive testing revealed only human herpesvirus-7 (HHV-7) in his cerebrospinal fluid.
- The patient was previously healthy.
Findings:
- This case represents the first documented instance of HHV-7 causing hemorrhagic brainstem encephalitis in an otherwise healthy individual.
- The patient recovered following treatment with intravenous immunoglobulin, high-dose steroids, and plasma exchange.
- This finding expands the known spectrum of HHV-7 associated encephalitis in children.
Implications:
- The study suggests HHV-7 can cause severe neurological disease in immunocompetent individuals.
- Early and aggressive immunosuppressive therapy, including intravenous immunoglobulin, steroids, and plasma exchange, may be beneficial for recovery.
- This case highlights the need to consider HHV-7 in the differential diagnosis of encephalitis, even in healthy patients.
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