Fulminant hepatitis with HHV-6 in a childhood patient

Abstract Neonates and young infants with human herpes virus 6 (HHV-6) may present with hepatitis, which is rarely fulminant. However, because HHV-6 is prevalent as a latent infection in humans, causality must be proven in patients with fulminant hepatitis. We describe a rare case of fulminant hepatitis induced by HHV-6 with concomitant central nervous system involvement and without any classic skin rash. An immunocompetent, breast-fed 14-month-old girl was admitted to our hospital because of gastrointestinal bleeding, fever, excessive sleepiness and inability to recognize parents, markedly elevated serum transaminase and severe coagulopathy. Cerebrospinal fluid polymerase chain reaction assay for viral agent was positive for HHV-6. Fortunately, the patient demonstrated a rapid improvement thereafter and did not require liver transplantation.

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