Acute human herpes virus 7 (HHV-7) encephalitis in an immunocompetent adult patient: a case report and review of literature

Infection. 2017 Jun;45(3):385-388. doi: 10.1007/s15010-017-1014-3. Epub 2017 Apr 6.

Abstract

We report a case of an acute HHV-7 encephalitis involving the nucleus of the VI cranial nerve in an immunocompetent host. The patient was an adult male admitted to our Clinic with headache, diplopia, fever, nausea, vertigo, asthenia and general malaise. PCR for viral and bacterial genomes was run on both serum and cerebral spinal fluid (CSF) after performing lumbar puncture, resulting positive only for HHV-7 DNA on CSF. MRI showed hyperintensity in FLAIR signal in the dorsal pons, in the area of the VI cranial nerve nucleus. Empirical therapy with Acyclovir and Dexamethasone was started at the time of admission and was continued after the microbiology results. After three days of therapy diplopia, fever and other previous clinical manifestations improved and the patient recovered normal sight. Our case report contributes to a better understanding of the presentation, diagnosis and treatment of HHV-7 encephalitis in immunocompetent patients due to reactivation in adult age.

Keywords: Diplopia; Encephalitis; HHV-7; Immunocompetent host.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acyclovir / therapeutic use
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Dexamethasone / therapeutic use
  • Diagnosis, Differential
  • Encephalitis / complications*
  • Encephalitis / diagnosis
  • Encephalitis / drug therapy
  • Encephalitis / virology*
  • Herpesvirus 7, Human / isolation & purification
  • Herpesvirus 7, Human / physiology*
  • Humans
  • Immunocompetence
  • Male
  • Radiculopathy / diagnosis
  • Radiculopathy / drug therapy
  • Radiculopathy / etiology
  • Radiculopathy / virology
  • Roseolovirus Infections / complications*
  • Roseolovirus Infections / diagnosis*
  • Roseolovirus Infections / drug therapy
  • Roseolovirus Infections / virology
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Dexamethasone
  • Acyclovir