Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients

Abstract Background This study sought to describe the clinical characteristics, examination results, and prognoses of immunocompetent children with human herpes virus 7 (HHV-7)-related severe encephalitis. Methods Twelve immunocompetent children with severe HHV-7-related encephalitis were included,...

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Main Authors: Xin Chen, Huan Zhao, Chunxue Jiang, Tingting Sun, Xuewen Xu, Kai You
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Virology Journal
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Online Access:https://doi.org/10.1186/s12985-025-02841-4
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author Xin Chen
Huan Zhao
Chunxue Jiang
Tingting Sun
Xuewen Xu
Kai You
author_facet Xin Chen
Huan Zhao
Chunxue Jiang
Tingting Sun
Xuewen Xu
Kai You
author_sort Xin Chen
collection DOAJ
description Abstract Background This study sought to describe the clinical characteristics, examination results, and prognoses of immunocompetent children with human herpes virus 7 (HHV-7)-related severe encephalitis. Methods Twelve immunocompetent children with severe HHV-7-related encephalitis were included, all of whom had HHV-7 DNA ( +) detected in the cerebrospinal fluid via metagenomic next-generation sequencing (mNGS) and were followed up for > 6 months. Results The cohort comprised 75% males, with a median age of 4.5 years; all patients presented with fever and altered consciousness and required PICU admission for severe neurological symptoms. Two patients developed encephalitis sequelae and epilepsy. Abnormal electroencephalography and brain magnetic resonance imaging findings were observed in 90.9% (10/11) and 72.7% (8/11) of the patients, respectively. Five patients required ventilator support due to central respiratory failure (four invasive and one noninvasive). One patient underwent plasma exchange, while another received continuous renal replacement therapy. All patients were treated with acyclovir and immunomodulatory therapy. Four patients had poor prognoses, including one 9-year-old male who died and one 9-year-old female who was diagnosed with febrile infection-related epilepsy syndrome and remained in a coma with a Modified Rankin Scale score of 5 at the 6-month follow-up. Conclusions Older immunocompetent children with severe HHV-7-related encephalitis have poor prognosis and low survival rates, both of which may be improved via empiric acyclovir administration combined with immunosuppressive therapy.
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spelling doaj-art-d58dea398db04df18d8b8747950fb7802025-08-24T11:07:51ZengBMCVirology Journal1743-422X2025-08-012211810.1186/s12985-025-02841-4Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patientsXin Chen0Huan Zhao1Chunxue Jiang2Tingting Sun3Xuewen Xu4Kai You5Department of Pediatrics, Shengjing Hospital of China Medical UniversityDepartment of Pediatrics, Shengjing Hospital of China Medical UniversityDepartment of Pediatrics, Shengjing Hospital of China Medical UniversityDepartment of Pediatrics, Shengjing Hospital of China Medical UniversityDepartment of Urology, Shengjing Hospital of China Medical UniversityDepartment of Pediatrics, Shengjing Hospital of China Medical UniversityAbstract Background This study sought to describe the clinical characteristics, examination results, and prognoses of immunocompetent children with human herpes virus 7 (HHV-7)-related severe encephalitis. Methods Twelve immunocompetent children with severe HHV-7-related encephalitis were included, all of whom had HHV-7 DNA ( +) detected in the cerebrospinal fluid via metagenomic next-generation sequencing (mNGS) and were followed up for > 6 months. Results The cohort comprised 75% males, with a median age of 4.5 years; all patients presented with fever and altered consciousness and required PICU admission for severe neurological symptoms. Two patients developed encephalitis sequelae and epilepsy. Abnormal electroencephalography and brain magnetic resonance imaging findings were observed in 90.9% (10/11) and 72.7% (8/11) of the patients, respectively. Five patients required ventilator support due to central respiratory failure (four invasive and one noninvasive). One patient underwent plasma exchange, while another received continuous renal replacement therapy. All patients were treated with acyclovir and immunomodulatory therapy. Four patients had poor prognoses, including one 9-year-old male who died and one 9-year-old female who was diagnosed with febrile infection-related epilepsy syndrome and remained in a coma with a Modified Rankin Scale score of 5 at the 6-month follow-up. Conclusions Older immunocompetent children with severe HHV-7-related encephalitis have poor prognosis and low survival rates, both of which may be improved via empiric acyclovir administration combined with immunosuppressive therapy.https://doi.org/10.1186/s12985-025-02841-4Human herpes virus-7ChildrenEncephalitisMetagenomic next-generation sequencingImmunocompetent
spellingShingle Xin Chen
Huan Zhao
Chunxue Jiang
Tingting Sun
Xuewen Xu
Kai You
Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients
Virology Journal
Human herpes virus-7
Children
Encephalitis
Metagenomic next-generation sequencing
Immunocompetent
title Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients
title_full Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients
title_fullStr Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients
title_full_unstemmed Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients
title_short Human herpes virus-7-related severe encephalitis diagnosed using mNGS in immunocompetent pediatric patients
title_sort human herpes virus 7 related severe encephalitis diagnosed using mngs in immunocompetent pediatric patients
topic Human herpes virus-7
Children
Encephalitis
Metagenomic next-generation sequencing
Immunocompetent
url https://doi.org/10.1186/s12985-025-02841-4
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