Evaluation of pediatric patients with Human Herpes Virus-6 and/or Human Herpes Virus-7 detected in cerebrospinal fluid: a single center experience

Abstract

Background: Human Herpes Virus-6, is a common cause of febrile seizures in infancy and has been associated with meningitis in this age group. Human Herpes Virus-7, may also cause meningitis in children. The role and frequency of HHV-6 and HHV-7 in children's central nervous system diseases is unclear and an area of ongoing research. In our study, we aimed to contribute to the literature about effects of Human Herpes Virus-6 and Human Herpes Virus-7 in central nervous system infections, in children.
Materials and methods: A retrospective study was conducted between March 2021 and March 2022. The study included children diagnosed with central nervous system infection and those found to have Human Herpes Virus-6 and or Human Herpes Virus-7 in their cerebrospinal fluid by multiplex real-time polymerase chain reaction.
Results: In our study, 86 children were hospitalized with the diagnoses of central nervous system infection. We detected Human Herpes Virus-6 and/or Human Herpes Virus-7 in cerebrospinal fluid in 12 (13.9%) children. When the patients were grouped according to their age, 75% were under the age of 2 years. Seizure was the presenting complaint in all patients with Human Herpes Virus-6 and 50% patients with Human Herpes Virus-7. Although the frequency of seizures was lower in the Human Herpes Virus-7, 75% of the seizures in this group were status epilepticus. Cerebral venous thrombosis was observed in 3 patients. All patients with thrombosis were found to be infected with Human Herpes Virus-7.
Conclusion: Our study findings show that Human Herpes Virus-6 and Human Herpes Virus-7 may be associated with central nervous system infections and severe neurological diseases in childhood. Our study makes an important contribution to the literature in this respect and shows the need for multicenter prospective studies.

Keywords

• Human Herpes Virus-6
• Human Herpes Virus-7
• meningitis
• children
• seizure

Beyin omurilik sıvısında Human Herpes Virus-6 ve/veya Human Herpes Virus-7 saptanan çocuk hastaların değerlendirilmesi-tek merkez deneyimi

Abstract

Giriş: Ekzantem subitum'un etiyolojik ajanı Human Herpes Virus-6, bebeklik döneminde ateşli nöbetlerin yaygın bir nedenidir ve bu yaş grubunda menenjit ile ilişkilendirilmiştir. Human Herpes Virus-7’de çocuklarda ekzantem subitum ve ateşli nöbetlerle ilişkili olup menenjite de neden olabilir. Human Herpes Virus-6 ve Human Herpes Virus-7'nin merkezi sinir sistemi hastalıklarındaki rolü ve sıklığı belirsizdir ve devam eden bir araştırma alanıdır. Çalışmamızda Human Herpes Virus-6 ve Human Herpes Virus-7 etkenlerinin çocukluk çağı merkezi sinir sistemi enfeksiyonlarındaki etkileri konusunda literatüre katkı sağlanması amaçlanmıştır.
Gereç ve yöntem: Çalışmamıza Mart 2021-Mart 2022 tarihlerinde, merkezi sinir sistemi enfeksiyonu öntanıları ile yatırılan, beyin omurilik sıvılarında polimeraz zincir reaksiyonu ile Human Herpes Virus-6, Human Herpes Virus-7 saptanan çocuk hastalar alındı. Çalışmaya dahil edilen hastaların epidemiyolojik, klinik, laboratuvar bulguları, tedavileri ve prognozları incelendi.
Bulgular: Çalışmamızda toplam 86 çocuk merkezi sinir sistemi enfeksiyonu öntanıları ile yatırıldı. Merkezi sinir sistemi enfeksiyonu öntanısı ile yatırılan çocuklardan 12’sinde (%13,9) beyin omurilik sıvısında polimeraz zincir reaksiyonu ile Human Herpes Virus-6 ve/veya Human Herpes Virus-7 saptandı. Hastaların 9’u (%75) iki yaş altındaydı. Nöbet Human Herpes Virus-6 ile enfekte olanların tümünde, Human Herpes Virus-7 ile enfekte olanların 4’ünde (%50) başvuru yakınmasıydı. Nöbet sıklığı Human Herpes Virus-7 grubunda daha az olmasına rağmen bu grupta nöbetlerin %75’i status idi. Kraniyal manyetik rezonans görüntüleme ile 3 hastada serebral venöz tromboz görüldü. Tromboz saptanan hastalarının tümünün Human Herpes Virus-7 ile enfekte olduğu saptandı.
Sonuç: Çalışmamızdan elde edilen sonuçlar Human Herpes Virus-6 ve Human Herpes Virus-7 etkenlerinin çocukluk çağında merkezi sinir sistemi enfeksiyonları ve ağır nörolojik hastalıklar ile ilişkili olabileceğini göstermektedir. Çocuklarda Human Herpes Virus-7 ilişkili vaskulopatiler, otoimmun ve otoinflamatuar süreçler ile ilgili henüz yeterli sayıda veri bulunmamaktadır. Çalışmamız bu açıdan literatüre önemli bir katkı sağlamakta, çok merkezli ve ileriye yönelik çalışmalar yapılması gerekliliğini göstermektedir.

Keywords

• Human Herpes Virus-6
• Human Herpes Virus-7
• menenjit
• pediatri
• nöbet

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