Human herpesvirus 6 (HHV-6) is a widely spread DNA virus that is ubiquitous and persistent with primary infection occurring in early childhood, with reactivation of the infection a common phenomenon in severely immunocompromised hosts, including hematopoietic stem cell transplant (HSCT) patients, influencing morbidity and mortality. A wide spectrum of clinical presentations is reported in the literature with HHV-6 reactivation including post-transplant limbic encephalitis (PALE). We report the unusual case of a 6-year-old female 107 days postallogenic HSCT due to transfusion dependent beta thalassemia major who developed acute cerebellitis with secondary supratentorial hydrocephalus that required invasive surgical intervention. In addition to accompanying imaging findings, the patient tested positive for HHV-6 by PCR from both serum and CSF samples and demonstrated dramatic improvement with the institution of steroid therapy in addition to ganciclovir treatment. The availability of rapid diagnostic measures in addition to a multidisciplinary approach is crucial to manage HHV-6 encephalitis and associated complications in HSCT patients.
Keyphrases
- hematopoietic stem cell
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- randomized controlled trial
- prognostic factors
- endothelial cells
- systematic review
- liver failure
- subarachnoid hemorrhage
- cardiac surgery
- intensive care unit
- patient reported outcomes
- risk factors
- mesenchymal stem cells
- single molecule
- brain injury
- cell therapy
- respiratory failure
- fluorescence imaging
- case report
- acute respiratory distress syndrome
- mechanical ventilation
- extracorporeal membrane oxygenation
- quality improvement