Many cases of viral meningitis are idiopathic, but increased utilization of polymerase chain reaction testing has enabled physicians to better recognize rare causes of viral meningitis. This will likely continue to improve the rate of causative agent identification in seemingly idiopathic viral meningitis, including this case of human herpesvirus 6 (HHV-6) meningitis in an immunocompetent adult patient. More common viral etiologies need to be excluded before diagnosing HHV-6 meningitis, as this maximizes pretest probability and therefore increases validity of a positive result. By efficiently diagnosing HHV-6 meningitis, proper treatment protocols can be initiated earlier to reduce morbidity and mortality. Given the rarity of HHV-6 meningitis in immunocompetent adults, there are no established standard treatment guidelines; previous reported cases, as well as this case, suggest that either intravenous ganciclovir or intravenous foscarnet are the most reasonable first-line treatment options.
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http://dx.doi.org/10.1080/08998280.2020.1719784 | DOI Listing |
Mikrobiyol Bul
October 2024
University of Health Sciences, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of Pediatric Infectious Diseases, İzmir, Türkiye.
Surg Neurol Int
August 2024
Division of Pediatric Neurosurgery, Children's Hospital Orange County, Orange, California, United States.
J Clin Med
August 2024
Faculty of General Medicine, Department of Infectious Diseases, "Carol Davila" University of Medicine and Pharmacy, Dionisie Lupu Street No. 37, 010458 Bucharest, Romania.
Mikrobiyol Bul
July 2024
Bursa Uludağ University Faculty of Medicine, Department of Medical Microbiology, Bursa, Türkiye.
Front Med (Lausanne)
April 2024
Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
Background: The Biofire FilmArray Meningitis/Encephalitis (ME) PCR panel covers 14 viral, bacterial, and fungal pathogens and has been implemented in many institutions worldwide. Post-marketing studies indicate a reduced sensitivity and overutilization underscoring the need for a more targeted usage. The aim of our study is to describe the utilization of the ME panel and to develop a diagnostic-stewardship based decision rule.
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