Zhen Yuan-Yuan, Yang Jing, Liao Pei-Yuan
Department of Pediatrics, Qilu Hospital of Shandong University (Qingdao), Qingdao 266035, Shandong Province, China.
World J Clin Cases. 2024 Jun 26;12(18):3636-3643. doi: 10.12998/wjcc.v12.i18.3636.
Human herpesvirus type 7 (HHV-7) is a less common herpes virus that usually causes mild, self-limiting illnesses. However, in recent years, there have been increasing reports of HHV-7 causing serious central nervous system infections, especially meningitis. The pathogenesis and clinical features of HHV-7 meningitis, particularly in adolescents with normal immune function, remain incompletely studied. Therefore, the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.
A 12-year-old female was admitted with fever, headache, and vomiting. 4 d before admission, the patient developed a fever without obvious induction, with a temperature up to 39.5 °C, no convulsions, accompanied by chills, headaches, fatigue, and no muscle aches. The patient was treated with fever reduction, which could be reduced to 38 °C; repeated high fever, accompanied by vomiting 7-8 times; and no abdominal pain or diarrhea. The patient was diagnosed with "acute suppurative tonsillitis" in a local hospital, and the blood routine was generally normal. The patient was given symptomatic support treatment such as "ceftriaxone sodium" and antiemetic rehydration for 2 d, and his condition did not improve. The patient's physical examination showed pharyngeal congestion, bilateral tonsil grade I hypertrophy, regression of purulent secretions, and cervical resistance. Ocular B-ultrasound: Opacity of the vitreous body and edema of the optic disc in both eyes. Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes, with edema of the optic disc. DNA virus monitoring results: HHV-7. We gave ganciclovir antiviral therapy, dexamethasone anti-inflammatory treatment, mannitol to reduce cranial pressure, omeprazole to protect gastrointestinal mucosa, and calcium and potassium supplementation.
This study reports a case of HHV-7 meningitis in an adolescent with normal immune function. Through comprehensive analysis of the clinical manifestations, laboratory tests, and treatment methods of the patient, it is found that early identification and antiviral treatment are essential for the outcome of the disease. This case suggests that despite normal immune function, adolescents may still suffer from herpes virus type 7 meningitis, so clinicians should be vigilant and take effective treatment measures in time.
人类疱疹病毒7型（HHV - 7）是一种较不常见的疱疹病毒，通常引起轻度、自限性疾病。然而，近年来，关于HHV - 7引起严重中枢神经系统感染，尤其是脑膜炎的报道日益增多。HHV - 7脑膜炎的发病机制和临床特征，特别是在免疫功能正常的青少年中，仍未得到充分研究。因此，本报告的目的是分享一例免疫功能正常的青少年HHV - 7脑膜炎病例，以加深我们对该疾病的理解。
一名12岁女性因发热、头痛和呕吐入院。入院前4天，患者无明显诱因出现发热，体温高达39.5℃，无惊厥，伴有寒战、头痛、乏力，无肌肉酸痛。患者接受退热治疗后体温可降至38℃；反复高热，伴有呕吐7 - 8次；无腹痛或腹泻。患者在当地医院被诊断为“急性化脓性扁桃体炎”，血常规大致正常。给予“头孢曲松钠”等对症支持治疗及止吐补液2天，病情无改善。患者体格检查显示咽部充血，双侧扁桃体Ⅰ度肿大，脓性分泌物消退，有颈抵抗。眼部B超：双眼玻璃体混浊，视盘水肿。光学相干断层扫描检查显示双眼黄斑中心凹大致正常，视盘水肿。DNA病毒监测结果：HHV - 7。给予更昔洛韦抗病毒治疗、地塞米松抗炎治疗、甘露醇降低颅内压、奥美拉唑保护胃肠道黏膜以及补充钙和钾。
本研究报告了一例免疫功能正常的青少年HHV - 7脑膜炎病例。通过对患者临床表现、实验室检查及治疗方法的综合分析，发现早期识别和抗病毒治疗对疾病的转归至关重要。该病例提示，尽管免疫功能正常，青少年仍可能患7型疱疹病毒脑膜炎，因此临床医生应保持警惕并及时采取有效治疗措施。
