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Case Reports
. 2023 Oct;51(10):3000605231204479.
doi: 10.1177/03000605231204479.

HHV-6B- and HHV-7-associated choroiditis secondary to acute myelogenous leukemia: a case report

Jing Xu  1 , Linjiang Chen  1 , Tao Cen  2 , Yuanping Zeng  3 , Qiong Liu  1
Affiliations
Case Reports

HHV-6B- and HHV-7-associated choroiditis secondary to acute myelogenous leukemia: a case report

Jing Xu et al. J Int Med Res. 2023 Oct.

Abstract

We report a case of human herpes virus 6 (HHV-6)- and human herpes virus 7 (HHV-7)-associated choroiditis in an immunocompromised woman. A 42-year-old Chinese woman with a history of acute myelogenous leukemia presented with blurred vision and black floaters in her right eye. Anterior segment examination findings were normal. Ophthalmoscopic examination revealed a subretinal lesion in the superonasal peripapillary region with several punctate hemorrhages. Optical coherence tomography showed a crater-like choroidal protuberance, associated with retinal pigment epithelium rupture and full-thickness retinal edema in the involved area. Indocyanine green angiography demonstrated a broad hypofluorescent lesion in the choroid. The patient was diagnosed with choroiditis. Subsequently, metagenomic next-generation sequencing revealed HHV-6B and HHV-7 DNA in the aqueous humor. Therefore, antiviral therapy was initiated. The patient experienced resolution of all symptoms and signs after treatment with intravenous foscarnet and oral acyclovir. The findings in this case indicate that HHV-6 and HHV-7 can cause ocular infection, particularly in immunocompromised patients.

Keywords: Human herpesvirus-6; case report; choroiditis; human herpesvirus-7; immunocompromised host; metagenomic next-generation sequencing.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Fundoscopy demonstrated an oval-shaped subretinal lesion, surrounded by several punctate hemorrhages in the superonasal peripapillary region of the right eye. The left eye was completely unaffected (a). Optical coherence tomography revealed a crater-like choroidal protuberance, associated with retinal pigment epithelium rupture and full-thickness retinal edema (b). Asterisks (*) indicate lesions.
Figure 2.
Figure 2.
Early (a) and late (b) phases of fluorescein angiography showed lesions with early hypofluorescence, following by an extensive area with late hyperfluorescence. Indocyanine green angiography (c) revealed a broad hypofluorescent lesion in the choroid. Asterisks (*) indicate lesions.
Figure 3.
Figure 3.
Optical coherence tomography revealed a more aggressive choroidal lesion, along with more extensive vitritis and retinitis in the right eye. Asterisks (*) indicate lesions.
Figure 4.
Figure 4.
Fundoscopy (a) and optical coherence tomography (b) revealed an atrophic and stabilized choroidal lesion in the right eye. Optical coherence tomography showed a normal fovea throughout the course of disease (c). Asterisks (*) indicate lesions.
See this image and copyright information in PMC

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