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Título

HUMAN HERPES VIRUS TYPE 7 VIRAL ENCEPHALITIS IN PEDIATRIC PATIENT: A CASE REPORT

Apresentação do caso

Male patient, 2 years and 7 months old, with a history of persistent fever secondary to
tonsillitis. He used Amoxicillin for 10 days, with an improvement in his fever, but during
the treatment he developed a behavioral change, characterized by significant agitation
and gait changes. On admission, irritability alternating with drowsiness, chewing
movements, patellar hyperreflexia, exhaustible clonus in the feet and refusal to put the
feet on the ground were observed. During hospitalization, he had a brief convulsive
episode, characterized by hyperextension of the right upper limb and gaze fixation.
Central Nervous System infection was suspected. Cerebrospinal fluid analysis showed
glucose 66 (finger prick test = 106) / protein 26.2 / leukocytes 48 / neutrophils 1% /
monocytes 5%/ lymphocytes 94%/ viral panel: Human Herpes Virus Type 7 (HHV-7).
Electroencephalogram with markedly disorganized background activity and voltage
attenuation in temporal regions. Brain magnetic resonance imaging compatible with
viral encephalitis. He received Ganciclovir for 21 days, with good motor response,
however, there was a worsening of agitation and stereotypies appeared. Later, the
stereotypies regressed, but other symptoms of Autism Spectrum Disorder were
observed.

Discussão

Infection by Human Herpes Virus Type 7 is common in childhood, affecting about 90%
of children up to 5 years of age. Its clinical presentation is wide, and the involvement of
the Central Nervous System is a recently recognized entity. In preschoolers, there is a
higher prevalence of febrile seizures and encephalitis is more common in older
children. After infection there is complete recovery, but with developmental
disturbances in the convalescence period. Loss of developmental milestones and
psychiatric disturbances observed during the infectious process are recovered. In the
reported case, the patient evolved with psychiatric disorders and is being followed up at
the outpatient clinic.

Comentários finais

When viral encephalitis is suspected, HHV-7 should be included, especially when the
patient has significant behavioral symptoms, since the treatment of choice is
Ganciclovir.

Palavras Chave

HUMAN HERPES VIRUS TYPE 7 VIRAL ENCEPHALITIS

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Não há conflito de interesses.