Abstract
BackgroundWe report a rare case of bilateral panuveitis from human herpes virus 6 (HHV-6) with genomic viral DNA integration in an immunocompromised man.FindingsA 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.ConclusionsHHV-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.
Highlights
We report a rare case of bilateral panuveitis from human herpes virus 6 (HHV-6) with genomic viral DNA integration in an immunocompromised man
HHV-6 DNA integration may lead to difficulties in disease diagnosis and determining disease resolution
While the seroprevalence in the adult population approaches 95%, and HHV-6 reactivations are known to be common after organ transplantation, clinical disease is rare after the primary infection [1]
Summary
We report a rare case of bilateral panuveitis from human herpes virus 6 (HHV-6) with genomic viral DNA integration in an immunocompromised man. We report the case of an immunocompromised man who presented with encephalitis and severe bilateral panuveitis as a result of HHV-6 reactivation. Integration of the viral genome into the host DNA, a unique characteristic of HHV-6, complicated the clinical management of our patient.
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