Smith Hayden Z, Paguia Richard, Horne John, Velagapudi Manasa
Infectious Diseases, Creighton University Medical Center, Omaha, USA.
Cureus. 2019 May 10;11(5):e4636. doi: 10.7759/cureus.4636.
We present a case of a 32-year-old woman with signs and symptoms of idiopathic intracranial hypertension (IIH), but who, upon further investigation, was found to have human herpesvirus-6 (HHV-6) in both cerebrospinal fluid (CSF) and serum. This rare cause of meningitis in an immunocompetent individual and a relatively unique presentation is described along with a review of proper diagnostic workup and treatment. HHV-6 meningitis is commonly detected via molecular diagnostics and thus needs confirmatory testing of viral load of acellular compartments or viral serology. The reason for this added diagnostic step is due to the incorporation of the virus into the host DNA, leading to increased false-positive results on screening tests. In this case, proper diagnosis, treatment, and follow-up were pursued by following guidelines proposed in the literature of HHV-6 meningitis.
我们报告了一例32岁女性病例,该患者有特发性颅内高压(IIH)的体征和症状,但进一步检查发现其脑脊液(CSF)和血清中均有人疱疹病毒6型(HHV-6)。本文描述了这种免疫功能正常个体中罕见的脑膜炎病因及相对独特的临床表现,并回顾了适当的诊断检查和治疗方法。HHV-6脑膜炎通常通过分子诊断检测,因此需要对无细胞成分的病毒载量或病毒血清学进行确证性检测。增加这一诊断步骤的原因是病毒整合到宿主DNA中,导致筛查试验出现更多假阳性结果。在本病例中,我们遵循HHV-6脑膜炎文献中提出的指南进行了正确的诊断、治疗和随访。