Alkozah Maria, Hallak Rami, Bou Akl Imad, El Zakhem Aline
Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Pulmonary and Critical Care Division, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
BMJ Case Rep. 2021 Mar 24;14(3):e239220. doi: 10.1136/bcr-2020-239220.
Human herpes virus-6 (HHV-6) infection is a common infection in the paediatric population and is increasingly reported in immunosuppressed adult patients. It has been reported as the causative agent of disease in few case reports in immunocompetent adults. We report herein an unusual case of HHV-6-associated viraemia, pneumonitis and meningitis in a patient who presented with dyspnoea, hypoxia, dry cough and headache. She was treated for atypical pneumonia with no improvement. Meningitis was suspected as headache kept worsening. HHV-6B was detected by PCR in the cerebrospinal fluid, and subsequently, in the bronchoalveolar lavage and serum samples. Studies were negative for the most common primary and secondary immunodeficiency syndromes, and serology could not be performed to differentiate virus reactivation from a primary infection. The patient was successfully treated with ganciclovir and had no residual sequelae.
人疱疹病毒6型（HHV-6）感染在儿科人群中很常见，免疫抑制的成年患者中报告也越来越多。在免疫功能正常的成年人的少数病例报告中，它被报道为疾病的病原体。我们在此报告一例不寻常的HHV-6相关病毒血症、肺炎和脑膜炎病例，患者表现为呼吸困难、缺氧、干咳和头痛。她接受了非典型肺炎治疗，但没有改善。由于头痛不断加重，怀疑患有脑膜炎。通过聚合酶链反应（PCR）在脑脊液中检测到HHV-6B，随后在支气管肺泡灌洗和血清样本中也检测到。针对最常见的原发性和继发性免疫缺陷综合征的检查均为阴性，且无法进行血清学检查以区分病毒再激活与原发性感染。该患者接受更昔洛韦治疗成功，且无残留后遗症。
