Human herpesvirus 6-associated uveitis with optic neuritis diagnosed by multiplex PCR

Jpn J Ophthalmol. 2011 Sep;55(5):502-505. doi: 10.1007/s10384-011-0069-4. Epub 2011 Aug 4.

Abstract

Purpose: Human herpesvirus 6 (HHV-6), which is usually responsible for exanthem subitum in children, can be reactivated from its latent state. We report a case of unilateral optic disc edema and retinal vasculitis associated with HHV-6 infection.

Case: A healthy 63-year-old man noted a decrease in the vision of his left eye. On examination, his left eye had moderate mutton-fat keratic precipitates, vitreous opacities, significant optic disc edema surrounded by yellowish-white swelling in the inner retina, retinal arteritis, and cotton-wool-like exudates. He was started on corticosteroid therapy and aspirin. After 1 month, the disc edema was reduced, the cotton wool-like exudates had decreased, and his visual acuity had improved to 10/20 OS. Multiplex polymerase chain reaction (PCR) of an aqueous humor sample revealed the presence of genomic DNA of HHV-6 but not of the other HHVs.

Conclusions: The HHVs are known to infect the ocular tissues, but the differential diagnostic signs of HHV-6 are still not well known. We recommend that multiplex PCR of the aqueous humor be performed to search for the genomic DNA of HHV-6 in suspected cases of herpesviral infection.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Aqueous Humor / virology*
  • Aspirin / administration & dosage
  • DNA Primers / chemistry
  • DNA, Viral / analysis
  • Exanthema Subitum / diagnosis*
  • Exanthema Subitum / drug therapy
  • Exanthema Subitum / virology
  • Fluorescein Angiography
  • Genome, Viral / genetics
  • Glucocorticoids / therapeutic use
  • Herpesvirus 6, Human / genetics
  • Herpesvirus 6, Human / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Multiplex Polymerase Chain Reaction / methods*
  • Papilledema / diagnosis*
  • Papilledema / drug therapy
  • Papilledema / virology
  • Prednisolone / therapeutic use
  • Retinal Vasculitis / diagnosis*
  • Retinal Vasculitis / drug therapy
  • Retinal Vasculitis / virology
  • Uveitis / diagnosis*
  • Uveitis / drug therapy
  • Uveitis / virology
  • Visual Acuity / physiology
  • Visual Field Tests

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • DNA Primers
  • DNA, Viral
  • Glucocorticoids
  • Prednisolone
  • Aspirin