Marseglia L, Manti S, D Angelo G, Stroscio G, Impollonia D, Arena S, Salpietro C, Gitto E
Department of Human Pathology in Adult and Developmental Age Gaetano Barresi University of Messina, Italy.
J Biol Regul Homeost Agents. 2016 Oct-Dec;30(4):1131-1136.
Human herpesviruses-6 and -7 (HHV-6 and 7) are considered uncommon causes of central nervous system infection and may occasionally cause encephalitis in young infants, however, the clinical syndrome and incidence are not well defined. In immunosuppressed hosts, reactivation is associated with a worse outcome such as encephalitis, hepatitis, or graft rejection. In immunocompetent hosts, this persistent infection is generally of no consequence. We report 4 cases of immunocompetent critically ill children, affected by HHV-6 and -7 encephalitis, admitted to our Pediatric Intensive Care Unit. In three patients, herpesvirus polymerase chain reaction in blood and cerebrospinal fluid was positive for HHV- 6, while one patient was positive for HHV-7. In our cases, a typical clinical picture of viral infection was not present but neurological symptoms were predominant. In all 4 children, neurological involvement rapidly regressed after acyclovir therapy. In this report, we offer evidence that HHV-6 and -7 primary infections can cause several clinical manifestations, such as encephalitis, also in immunocompetent hosts. In our experience, children with neurological symptoms suggestive of viral encephalitis should be fully investigated for these two viruses.
人类疱疹病毒6型和7型（HHV - 6和HHV - 7）被认为是中枢神经系统感染的罕见病因，偶尔可导致幼儿发生脑炎，然而，其临床综合征和发病率尚未明确界定。在免疫抑制宿主中，病毒再激活与更严重的后果相关，如脑炎、肝炎或移植物排斥反应。在免疫功能正常的宿主中，这种持续性感染通常并无大碍。我们报告了4例免疫功能正常的重症儿童，因感染HHV - 6和HHV - 7脑炎入住我们的儿科重症监护病房。3例患者血液和脑脊液中的疱疹病毒聚合酶链反应显示HHV - 6呈阳性，1例患者HHV - 7呈阳性。在我们的病例中，未出现典型的病毒感染临床表现，但以神经症状为主。所有4例儿童在接受阿昔洛韦治疗后，神经受累情况迅速缓解。在本报告中，我们提供证据表明，HHV - 6和HHV - 7原发性感染在免疫功能正常的宿主中也可引起多种临床表现，如脑炎。根据我们的经验，对于有提示病毒性脑炎神经症状的儿童，应全面检查这两种病毒。
