Retinitis linked to human herpesvirus type 6: a case study in a splenectomised patient

Abstract

Human herpesvirus-6 (HHV-6) is a member of the HHV family and is a rare cause of infectious uveitis. We report a case of a splenectomised patient, hospitalised due to invasive pneumococcal disease, who was diagnosed with retinitis in the right eye, with good visual acuity (0.1 LogMAR). Given the presence of HHV-6 Polymerase chain reaction (PCR) in the cerebrospinal fluid and the serum and the coexistence of a severe central nervous system infection, the ophthalmological features were attributed to the HHV-6 infection. He was treated with topical corticosteroid eyedrops, cyclopentolate, and prednisolone acetate ointment and systemically with intravenous ganciclovir 5 mg/kg bid for 14 days and then oral valganciclovir 900 mg bid for 4 weeks. The diagnosis was promptly presumed, enabling the early initiation of appropriate treatment and contributing to the preservation of the good visual acuity initially observed.

Picture 1

(A) OD - The macula presented hemorrhages near the the superior temporal arcade; (B) In the nasal periphery, a creamy lesion was identified with about two optic discs in diameter, with ill-defined edges, and several hemorrhages around it

Picture 2

OCT macular exam OD (A) and OS (B)

Picture 3 OD -

(A) Posterior pole without hemorrhages. (B) In the nasal periphery, the retinal lesion appeared to be less active, with fewer hemorrhages in the area

Picture 4 OD -

(A) Optic disc and macula unremarkable. (B) In the nasal periphery, the retinal lesion presented signs of cicatrization