A Case of Bilateral Human Herpes Virus 6 Panuveitis with Genomic Viral DNA Integration

Overview

Journal J Ophthalmic Inflamm Infect

Publisher Springer

Specialty Ophthalmology

Date 2014 Jul 5

PMID 24995045

Citations 4

Authors

Jasmina Bajric

Wendy M Smith

Affiliations

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Abstract

Background: We report a rare case of bilateral panuveitis from human herpes virus 6 (HHV-6) with genomic viral DNA integration in an immunocompromised man.

Findings: A 59-year-old man with history of multiple myeloma presented with altered mental status, bilateral eye redness, and blurry vision. Examination revealed bilateral diffuse keratic precipitates, 4+ anterior chamber cell, hypopyon, vitritis, and intraretinal hemorrhages. Intraocular fluid testing by polymerase chain reaction (PCR) was positive for HHV-6. The patient was successfully treated with intravitreal foscarnet and intravenous ganciclovir and foscarnet. Despite clinical improvement, his serum HHV-6 levels remained high, and it was concluded that he had HHV-6 chromosomal integration.

Conclusions: HHV-6 should be considered in the differential for infectious uveitis in immunocompromised hosts who may otherwise have a negative work-up. HHV-6 DNA integration may lead to difficulties in disease diagnosis and determining disease resolution.

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