A case of acute necrotising encephalitis secondary to human herpesvirus 6 infection.
Summary
Online ahead of print. Review Article A case of acute necrotising encephalitis secondary to human herpesvirus 6 infection. Shinaman G(1), Lewandowski E(2), Wozniak G(3), Guo J(3), Thompson-Stone R(4), Owlett L(4), Ma H(3). Author information: (1)Department of Physical Medicine and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: gregoryshinaman@urmc.rochester.edu. (2)Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA. (3)Department of
Content
# Online ahead of print.
*Review Article*
A case of acute necrotising encephalitis secondary to human herpesvirus 6
infection.
Shinaman G(1), Lewandowski E(2), Wozniak G(3), Guo J(3), Thompson-Stone R(4),
Owlett L(4), Ma H(3).
Author information:
(1)Department of Physical Medicine and Rehabilitation, University of Rochester
Medical Center, Rochester, NY, USA. Electronic address:
gregory_shinaman@urmc.rochester.edu.
(2)Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA.
(3)Department of Physical Medicine and Rehabilitation, University of Rochester
Medical Center, Rochester, NY, USA.
(4)Department of Neurology, University of Rochester Medical Center, Rochester,
NY, USA.
In this Clinical Rounds, we present the case of a girl aged 11 months who
developed acute necrotising encephalitis in the setting of human herpesvirus 6
infection, complicated by elevated intracranial pressure, seizures, and
development of increased tone. This patient presented with common features of
acute necrotising encephalitis including fever, seizures, altered level of
consciousness, and focal neurological deficits. We discuss the investigations
for acute necrotising encephalitis, which is extensive and includes serology,
often showing thrombocytopenia and liver dysfunction. Cerebrospinal fluid
studies can show elevated protein without pleocytosis of white blood cells.
Imaging can show signal intensity changes on T2-weighted images in the bilateral
thalami, basal ganglia, subcortical white matter, cerebellum, and brainstem, in
addition to restricted diffusion. In this Clinical Rounds, we also highlight the
importance of rapid treatment, which includes immunosuppression with
corticosteroids, intravenous immunoglobulin, and plasma exchange. Finally, we
discuss the poor outcomes and prognosis for patients diagnosed with acute
necrotising encephalitis, with a 27% mortality rate and moderate to severe
disability in 63% of survivors.
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DOI: 10.1016/S0140-6736(26)00252-7