Meningomielitis asociadas a infección por herpes virus humano 7: Comunicación de dos casos

Abstract

Meningomyelitis associated with infection by human herpes virus 7. Report of two cases (Rev Med Chile 2011; 139: 1588-1591.

Human herpesvirus-7 Meningitis in an Immunocompetent Adult Patient: a Case Report

“…One recent retrospective study over a 4-year period, showed that among 251 immunocompetent adults with neurological symptoms, a total of six cases were related to HHV-7: four meningitis cases, one myelitis case and one encephalitis case [ 17 ]. Another two cases of meningoencephalitis due to HHV-7 were reported in Chile [ 18 ], two cases of encephalitis [ 5 ] in Italy with one of them involving the nucleus of the VI cranial nerve [ 19 ] and one case of limbic encephalitis in Japan [ 8 ]. Generally, the diagnosis was made by PCRs on body fluids.…”

“…Such method detects the nucleic acid in CSF particularly when obtained during the first week of symptoms onset, with a specificity of 99% and a sensitivity of 96%, while these percentages drop significantly after the second week [ 20 ]. Taking into consideration that HHV-7 was detected in normal brains [ 18 ], some studies support the fact that HHV-7 was detected in pia mater meninges, frontal lobe, temporal lobe and olfactory tract of individuals with encephalopathy [ 21 ] and controversial studies are still debating the role of HHV-7 in the pathogenesis of the Alzheimer disease [ 22 ]. More research is required to understand the role of HHV-7 in determining prognosis in immunocompetent adults.…”

Update on human herpesvirus 7 pathogenesis and clinical aspects as a roadmap for future research

“…One study also linked the presence of HHV-7 DNA and antigens in the brain to inflammatory-mediated hippocampal sclerosis and drug-resistant epilepsy ( 166 ). Other neurological disorders such as encephalitis, meningitis, myelitis, cerebellitis, neuritis, and meningo- or myeloradiculopathy (e.g., Guillian Barré syndrome) have also been observed during ongoing HHV-7 infection ( 6 , 128 , 129 , 139 – 141 , 143 – 158 , 160 – 165 , 167 , 168 , 170 ). In most cases, CNS manifestations ranging from nausea, sensitivity to light, and a stiff neck to ataxia and paralysis were accompanied by the detection of HHV-7 nucleic acids in cerebrospinal fluid (CSF) and/or synthesis of intrathecal anti-HHV-7 antibodies ( 6 , 129 , 140 , 141 , 143 – 158 , 160 – 164 , 167 , 168 ).…”

“…Other neurological disorders such as encephalitis, meningitis, myelitis, cerebellitis, neuritis, and meningo- or myeloradiculopathy (e.g., Guillian Barré syndrome) have also been observed during ongoing HHV-7 infection ( 6 , 128 , 129 , 139 – 141 , 143 – 158 , 160 – 165 , 167 , 168 , 170 ). In most cases, CNS manifestations ranging from nausea, sensitivity to light, and a stiff neck to ataxia and paralysis were accompanied by the detection of HHV-7 nucleic acids in cerebrospinal fluid (CSF) and/or synthesis of intrathecal anti-HHV-7 antibodies ( 6 , 129 , 140 , 141 , 143 – 158 , 160 – 164 , 167 , 168 ). Of note, HHV-7-specific antibodies or DNA were usually not accompanied by the presence of other viral DNA or antibodies, ruling out potential leakage through the blood-brain barrier (BBB) and indicating that HHV-7 can invade the nervous system.…”