Lynch Megan, Nedjat-Haiem Matthew, Abeson Kylie, Chang Celia
School of Medicine, University of California at Davis, Sacramento, USA.
Department of Pediatrics, University of California at Davis School of Medicine, Sacramento, USA.
Child Neurol Open. 2023 Oct 10;10:2329048X231206935. doi: 10.1177/2329048X231206935. eCollection 2023 Jan-Dec.
Despite the ubiquitous nature of human herpesvirus-7 (HHV-7) infection, its clinical significance in the central nervous system (CNS) is poorly understood. However, the related human herpesvirus-6 (HHV-6), which has remarkable genomic similarity to HHV-7, is linked to encephalitis. We present the case of a 17-year-old immunocompetent male with remote history of seizure who arrived in status epilepticus. Upon resolution, he required hospitalization for worsening encephalopathy. Electroencephalogram (EEG) revealed bilateral temporal lobe dysfunction and magnetic resonance imaging (MRI) showed increased signaling in bilateral medial temporal lobes with hippocampal microhemorrhages. Empiric intravenous (IV) acyclovir was initiated despite initially negative cerebrospinal fluid (CSF) studies due to concern for herpes simplex virus (HSV) encephalitis. The patient improved and was discharged on hospital day 13 (HD13). After discharge, a human metagenomics CSF panel resulted positive only for HHV-7, making a case for possible etiology and empiric treatment of HHV-7 despite delayed CSF and serum studies.
尽管人类疱疹病毒7型（HHV - 7）感染普遍存在，但其在中枢神经系统（CNS）中的临床意义仍知之甚少。然而，与之相关的人类疱疹病毒6型（HHV - 6）与HHV - 7在基因组上有显著相似性，且与脑炎有关。我们报告一例17岁免疫功能正常的男性病例，该患者有癫痫发作史，此次以癫痫持续状态入院。癫痫发作缓解后，他因脑病加重而需要住院治疗。脑电图（EEG）显示双侧颞叶功能障碍，磁共振成像（MRI）显示双侧内侧颞叶信号增强，伴有海马微出血。尽管最初脑脊液（CSF）检查结果为阴性，但出于对单纯疱疹病毒（HSV）脑炎的担忧，仍开始经验性静脉注射阿昔洛韦治疗。患者病情好转，于住院第13天（HD13）出院。出院后，人类宏基因组学脑脊液检测仅显示HHV - 7呈阳性，尽管脑脊液和血清检查延迟，但这为HHV - 7可能的病因及经验性治疗提供了依据。
