1. Reduced impact of viral load of HHV-6 in liquor on severity of AESD due to exanthema subitum: A case report and literature review
- Author
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Masanori Sato, Mitsuo Motobayashi, Ayaka Kasai, Yuji Inaba, Jun Shimizu, and Masatomo Kitamura
- Subjects
Poor prognosis ,business.industry ,viruses ,medicine.medical_treatment ,Acute encephalopathy ,General Medicine ,Case presentation ,Exanthema Subitum ,Targeted temperature management ,Pathophysiology ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Developmental Neuroscience ,Pediatrics, Perinatology and Child Health ,Immunology ,Medicine ,Neurology (clinical) ,business ,Viral load ,030217 neurology & neurosurgery - Abstract
Background The most common causative pathogen of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) was reported as HHV-6. Although excitotoxic injury with delayed neuronal death is considered to be a possible pathogenesis of AESD, the detailed pathophysiology remains unclear. Case presentation We present a twelve-month-old girl with AESD due to HHV-6 primary infection. She was successfully treated for AESD including targeted temperature management and the administration of vitamin B1, B6, and L-carnitine. Although the viral load of HHV-6 in her liquor was high (12,000 copies/mL), she fully recovered without antiviral agent use. Discussion There has been no study focusing on the HHV-6 viral load in patients with AESD, and only a few case reports have been published. We reviewed the clinical features and viral load in the liquor of our case and four reported infants with AESD due to HHV-6 primary infection who had real-time PCR tests results. Viral loads in the three patients with a poor prognosis were 31.5, negative, and 3,390 copies/mL, respectively. On the other hand, the copy numbers of HHV-6 DNA in the two patients with no sequelae were 12,000 and 106 copies/mL, respectively, and our case had the highest viral load among the five summarized patients.
- Published
- 2021