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. 2014 Jun 19:4:16.
doi: 10.1186/s12348-014-0016-x. eCollection 2014.

A case of bilateral human herpes virus 6 panuveitis with genomic viral DNA integration

Jasmina Bajric  1 , Wendy M Smith  1
Affiliations

A case of bilateral human herpes virus 6 panuveitis with genomic viral DNA integration

Jasmina Bajric et al. J Ophthalmic Inflamm Infect. .

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.

Keywords: Chromosomal integration; HHV-6; Human herpes virus-6; Immunocompromise; PCR; Panuveitis.

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Figures

Figure 1
Figure 1
Left-eye fundus photo 1 week after the initial presentation with dense vitritis and retinal hemorrhages.
Figure 2
Figure 2
Left-eye color montage photograph 2 weeks after the initial presentation with improved vitritis. Intraretinal hemorrhages and diffuse retinal opacification can be appreciated.
Figure 3
Figure 3
Left-eye color montage 6 months after the initial presentation showing resolution of vitritis, intraretinal hemorrhages, and retinitis.
See this image and copyright information in PMC

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