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Human herpesvirus-6 encephalitis following chemotherapy induction for acute myelogenous leukemia

John W Frey1, Joseph N Cherabie2, Maha A Assi3

  • 1Kansas City University of Medicine and Biosciences, Kansas City, MO, USA.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|July 27, 2017
PubMed

Insights

Human herpesvirus-6 (HHV-6) encephalitis occurred in a neutropenic patient undergoing chemotherapy. Diagnosis via PCR led to successful ganciclovir treatment, highlighting HHV-6 as a cause of encephalopathy in immunocompromised individuals.

Area of Science:

  • Neurovirology
  • Hematology Oncology

Background:

  • Neutropenic patients undergoing chemotherapy for acute myelogenous leukemia are susceptible to opportunistic infections.
  • Encephalopathy in immunocompromised patients can have diverse etiologies, necessitating broad diagnostic considerations.

Observation:

  • A patient presented with confusion, amnesia, and lethargy during chemotherapy induction.
  • Cerebrospinal fluid analysis revealed human herpesvirus-6 (HHV-6) via polymerase chain reaction.
  • Cranial imaging and electroencephalogram were unremarkable, complicating initial diagnosis.

Findings:

  • Polymerase chain reaction (PCR) confirmed human herpesvirus-6 (HHV-6) as the causative agent of encephalitis.
  • The patient received ganciclovir treatment, leading to a successful clinical recovery.
  • Broad-spectrum antimicrobial therapy did not prevent or treat the HHV-6 encephalitis.

Implications:

  • HHV-6 encephalitis should be considered in the differential diagnosis of encephalopathy in neutropenic and immunocompromised patients.
  • Early diagnosis of HHV-6 encephalitis using molecular methods like PCR is crucial for timely and effective treatment.
  • This case underscores the importance of considering viral etiologies beyond bacterial infections in immunocompromised patients with neurological symptoms.
Keywords:
acute myelogenous leukemiaencephalitishuman herpesvirus-6immunocompromised

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