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Severe Human Herpesvirus 7 Infection in Healthy Children
Hisao Okabe1, Masatoki Sato1, Sakurako Norito1
1Department of Pediatrics, School of Medicine, Fukushima Medical University.
Insights
Severe human herpesvirus 7 (HHV-7) infection, previously thought rare in children, can be fatal. This case series highlights severe outcomes like encephalopathy and myocarditis in immunocompetent children, emphasizing the need for aggressive HHV-7 testing.
Area of Science:
- Pediatrics
- Virology
- Infectious Diseases
Background:
- Human herpesvirus 7 (HHV-7) is a common virus infecting most children.
- Severe HHV-7 infections are considered rare in immunocompetent individuals.
Purpose of the Study:
- To report the clinical findings and courses of severe HHV-7 infections in three immunocompetent children.
- To highlight the potential for severe outcomes, including fatal encephalopathy and myocarditis with sequelae.
Main Methods:
- Case series analysis of three pediatric patients with severe HHV-7 infection.
- Detection of HHV-7 DNA in acute phase specimens (serum) using real-time PCR.
- Detection of HHV-7 DNA in myocardial tissue in a myocarditis case.
Main Results:
- Two patients (6 and 4 years old) presented with fatal encephalopathy.
- One patient (22 months old) developed severe sequelae after myocarditis, requiring extracorporeal membrane oxygenation.
- HHV-7 DNA was confirmed in serum and, in one case, myocardial tissue.
Conclusions:
- Severe HHV-7 infection can occur in immunocompetent children, leading to fatal or debilitating outcomes.
- Aggressive virological investigation for HHV-7 is crucial in cases of severe pediatric infections.
- Accumulating case data is essential to understand the full spectrum of severe HHV-7 disease.
Abstract:
Human herpesvirus 7 (HHV-7) is ubiquitous and infects most children. Severe HHV-7 infection was considered to be rare. In this case series, we report the clinical findings and clinical courses of three immunocompetent children who had severe HHV-7 infection: two fatal cases of encephalopathy and one patient with severe sequelae after myocarditis. In all three patients, HHV-7 DNA was detected in acute phase specimens, including serum by real-time PCR. In the myocarditis case, HHV-7 DNA was also detected in myocardial tissue, suggesting that HHV-7 was the cause. Patient 1 was a 6-year-old Japanese girl with encephalopathy who died one day after onset. Patient 2 was a 4-year-old Japanese girl with encephalopathy whose absence of brainstem reflexes was confirmed and died 29 days after onset. Patient 3 was a 22-month-old Japanese girl with myocarditis who managed with extracorporeal membrane oxygenation and survived but was left with severe neurological sequelae. Because HHV-7 can cause serious outcomes in children, a virological search for HHV-7 in severe infections needs to be aggressive, and cases should be accumulated.
