Acute Human Herpesvirus-7-associated Encephalitis in a Young Adult Coinfected with Herpes Simplex Virus -1/2 and Epstein-Barr Virus

Abstract

Background: Herpesvirus encephalitis (HVE) is a serious threat to people's health and life. The most common cause of these is herpes simplex virus. On the contrary, only isolated cases of encephalitis associated with herpesvirus type 7 are described. Objective: To describe a case of acute encephalitis in a young adult caused by uncommon Human herpesvirus 7 (HHV-7), underlying with Herpes simplex virus 1/2 (HSV-1/2) and Epstein-Barr virus (EBV) coinfection. Results: A 20-years-old woman presented to The Center of Infectious Disorders of the Nervous System (Kyiv, Ukraine) after developing acute fever followed by a left side partial loss of hearing. Her physical examination showed slow mentation and generalized weakness. Cerebrospinal fluid (CSF) analysis revealed pleocytosis of 15 cell/µl (45% lymphocytes, 55% granulocytes), and HHV-7 DNA (3.35 log genome copies per ml). CSF also contained IgG antibodies against HSV-1/2 and EBV capsid antigen (CA). No HHVs DNA nor antibodies to viral proteins were detected in the blood. Areas of mild increased signal in parietal lobes were detected on an MRI brain scan. After treating with Ganciclovir the patient was discharged in good condition. Conclusion: The author presents a case of primary HHV-7 infection followed acute encephalitis with typical MRI findings and HHV-7 DNA in CSF PCR. Ganciclovir therapy results in complete virology and neurological recovery. This case may be useful for clinicians in the differential diagnosis of CNS infection, taking into account that HHV-7 may be an etiological factor, and a timely diagnosis is the most important imperative for successful treatment.