Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case

Background. Immune system disorders early after COVID-19 are associated with high risk of other infections development, including viral ones. Their diagnosis is complicated especially in the absence of clinical symptoms of primary infection and alongside with serious disease course. There are no rep...

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Main Authors: Rashid A. Zhetishev, Diana R. Arkhestova, Oksana A. Pacheva, Lidiya R. Dinaeva, Elena A. Kamyshova, Zhanna Yu. Pazova
Format: Article
Language:English
Published: "Paediatrician" Publishers LLC 2023-07-01
Series:Вопросы современной педиатрии
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Online Access:https://vsp.spr-journal.ru/jour/article/view/3227
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author Rashid A. Zhetishev
Diana R. Arkhestova
Oksana A. Pacheva
Lidiya R. Dinaeva
Elena A. Kamyshova
Zhanna Yu. Pazova
author_facet Rashid A. Zhetishev
Diana R. Arkhestova
Oksana A. Pacheva
Lidiya R. Dinaeva
Elena A. Kamyshova
Zhanna Yu. Pazova
author_sort Rashid A. Zhetishev
collection DOAJ
description Background. Immune system disorders early after COVID-19 are associated with high risk of other infections development, including viral ones. Their diagnosis is complicated especially in the absence of clinical symptoms of primary infection and alongside with serious disease course. There are no reports on encephalitis development due to reactivation of latent viral infection.Clinical case description. Girl, 4 years-old, had psycho-neurological symptoms followed by tonic seizures on the next day. The child was hospitalized on the 3rd day after disease onset with preliminary diagnosis of viral encephalitis. The child has contacted with patients with laboratory-confirmed new coronavirus infection 3-4 weeks before the disease onset, later she had signs of mild respiratory infection (no examination of SARS-CoV-2 was carried out). Autoimmune nature of central nervous system injury was suspected after excluding a wide range of infections (negative PCR results for SARS-CoV-2, cytomegalovirus, herpes simplex virus, Epstein-Barr virus, toxoplasma, enterovirus), however it was not confirmed later on. Human herpes virus type 6 was revealed via blood tests and oropharyngeal swаb on the 15th day of disease. High concentration of IgG antibodies to SARS-CoV-2 was found was revealed as well. Treatment (antibacterial, anticonvulsant, anticoagulant, antiviral, immunosupportive, and sedative therapy, glucocorticosteroids) did not achieve significant improvement. Brain MRI (on the 23rd day of the disease) has shown leukoencephalopathy zones in subcortical white matter of convexital surfaces of parietal and occipital lobes, subatrophic changes in white matter of cerebral hemispheres with moderate vicarious enlargement of the subarachnoid spaces. Disease progression led to patient’s death on the 32nd day after first signs appearance.Conclusion. The development of severe viral encephalitis (as a result of primary herpes virus infection or its reactivation) in the early period after mild COVID-19 is shown. Its cause-effect relations require further examination.
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series Вопросы современной педиатрии
spelling doaj-art-7f11051521324d87ac7448d80378e9b32025-08-20T03:21:55Zeng"Paediatrician" Publishers LLCВопросы современной педиатрии1682-55271682-55352023-07-0122326327010.15690/vsp.v22i3.25882105Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical CaseRashid A. Zhetishev0Diana R. Arkhestova1Oksana A. Pacheva2Lidiya R. Dinaeva3Elena A. Kamyshova4Zhanna Yu. Pazova5Kabardino-Balkarian State University named after H.M. Berbekov; Republican Children’s Multidisciplinary Medical CenterKabardino-Balkarian State University named after H.M. Berbekov; Republican Children’s Multidisciplinary Medical CenterRepublican Children’s Multidisciplinary Medical CenterRepublican Children’s Multidisciplinary Medical CenterKabardino-Balkarian State University named after H.M. BerbekovKabardino-Balkarian State University named after H.M. BerbekovBackground. Immune system disorders early after COVID-19 are associated with high risk of other infections development, including viral ones. Their diagnosis is complicated especially in the absence of clinical symptoms of primary infection and alongside with serious disease course. There are no reports on encephalitis development due to reactivation of latent viral infection.Clinical case description. Girl, 4 years-old, had psycho-neurological symptoms followed by tonic seizures on the next day. The child was hospitalized on the 3rd day after disease onset with preliminary diagnosis of viral encephalitis. The child has contacted with patients with laboratory-confirmed new coronavirus infection 3-4 weeks before the disease onset, later she had signs of mild respiratory infection (no examination of SARS-CoV-2 was carried out). Autoimmune nature of central nervous system injury was suspected after excluding a wide range of infections (negative PCR results for SARS-CoV-2, cytomegalovirus, herpes simplex virus, Epstein-Barr virus, toxoplasma, enterovirus), however it was not confirmed later on. Human herpes virus type 6 was revealed via blood tests and oropharyngeal swаb on the 15th day of disease. High concentration of IgG antibodies to SARS-CoV-2 was found was revealed as well. Treatment (antibacterial, anticonvulsant, anticoagulant, antiviral, immunosupportive, and sedative therapy, glucocorticosteroids) did not achieve significant improvement. Brain MRI (on the 23rd day of the disease) has shown leukoencephalopathy zones in subcortical white matter of convexital surfaces of parietal and occipital lobes, subatrophic changes in white matter of cerebral hemispheres with moderate vicarious enlargement of the subarachnoid spaces. Disease progression led to patient’s death on the 32nd day after first signs appearance.Conclusion. The development of severe viral encephalitis (as a result of primary herpes virus infection or its reactivation) in the early period after mild COVID-19 is shown. Its cause-effect relations require further examination.https://vsp.spr-journal.ru/jour/article/view/3227childrenherpes virus infectionsencephalitiscovid-19
spellingShingle Rashid A. Zhetishev
Diana R. Arkhestova
Oksana A. Pacheva
Lidiya R. Dinaeva
Elena A. Kamyshova
Zhanna Yu. Pazova
Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case
Вопросы современной педиатрии
children
herpes virus infections
encephalitis
covid-19
title Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case
title_full Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case
title_fullStr Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case
title_full_unstemmed Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case
title_short Viral Encephalitis (Human Herpes Virus Type 6) after COVID-19 in a Child: Clinical Case
title_sort viral encephalitis human herpes virus type 6 after covid 19 in a child clinical case
topic children
herpes virus infections
encephalitis
covid-19
url https://vsp.spr-journal.ru/jour/article/view/3227
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AT oksanaapacheva viralencephalitishumanherpesvirustype6aftercovid19inachildclinicalcase
AT lidiyardinaeva viralencephalitishumanherpesvirustype6aftercovid19inachildclinicalcase
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