Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3636-3643
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3636
Human herpesvirus 7 meningitis in an adolescent with normal immune function: A case report
Yuan-Yuan Zhen, Jing Yang, Pei-Yuan Liao
Yuan-Yuan Zhen, Jing Yang, Pei-Yuan Liao, Department of Pediatrics, Qilu Hospital of Shandong University (Qingdao), Qingdao 266035, Shandong Province, China
Author contributions: Zhen YY analyzed the data and wrote the paper; Liao PY designed and guided the research; Yang J collected and downloaded the data of the research. All the authors revised it critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/.
Corresponding author: Pei-Yuan Liao, PhD, Doctor, Department of pediatrics, Qilu Hospital of Shandong University (Qingdao), No. 758 Hefei Road, Shibei District, Qingdao 266035, Shandong Province, China. lpy020240@qlyyqd.com
Received: March 22, 2024
Revised: April 21, 2024
Accepted: May 7, 2024
Published online: June 26, 2024
Processing time: 88 Days and 1.4 Hours
Abstract
BACKGROUND

Human herpesvirus type 7 (HHV-7) is a less common herpes virus that usually causes mild, self-limiting illnesses. However, in recent years, there have been increasing reports of HHV-7 causing serious central nervous system infections, especially meningitis. The pathogenesis and clinical features of HHV-7 meningitis, particularly in adolescents with normal immune function, remain incompletely studied. Therefore, the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.

CASE SUMMARY

A 12-year-old female was admitted with fever, headache, and vomiting. 4 d before admission, the patient developed a fever without obvious induction, with a temperature up to 39.5 °C, no convulsions, accompanied by chills, headaches, fatigue, and no muscle aches. The patient was treated with fever reduction, which could be reduced to 38 °C; repeated high fever, accompanied by vomiting 7-8 times; and no abdominal pain or diarrhea. The patient was diagnosed with "acute suppurative tonsillitis" in a local hospital, and the blood routine was generally normal. The patient was given symptomatic support treatment such as "ceftriaxone sodium" and antiemetic rehydration for 2 d, and his condition did not improve. The patient's physical examination showed pharyngeal congestion, bilateral tonsil grade I hypertrophy, regression of purulent secretions, and cervical resistance. Ocular B-ultrasound: Opacity of the vitreous body and edema of the optic disc in both eyes. Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes, with edema of the optic disc. DNA virus monitoring results: HHV-7. We gave ganciclovir antiviral therapy, dexamethasone anti-inflammatory treatment, mannitol to reduce cranial pressure, omeprazole to protect gastrointestinal mucosa, and calcium and potassium supplementation.

CONCLUSION

This study reports a case of HHV-7 meningitis in an adolescent with normal immune function. Through comprehensive analysis of the clinical manifestations, laboratory tests, and treatment methods of the patient, it is found that early identification and antiviral treatment are essential for the outcome of the disease. This case suggests that despite normal immune function, adolescents may still suffer from herpes virus type 7 meningitis, so clinicians should be vigilant and take effective treatment measures in time.

Keywords: Human herpesvirus 7 meningitis, Immune function, Immune deficiency, Central system infection, Case report

Core Tip: This study reports an immunologically normal adolescent case of human herpesvirus 7 meningitis. The pathogenesis and clinical manifestations of the virus in healthy individuals were discussed by describing the clinical manifestations, laboratory findings, and imaging features of the patients in detail. The case reminds doctors to be alert to rare infections that may occur in individuals with normal immune function and to enhance awareness of the disease for timely diagnosis and treatment.