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Table 1 Clinical features, diagnosis, and treatment of similar cases reported in the literature

From: Encephalitis associated with human herpesvirus-7 infection in an immunocompetent adult

Clinical diagnosis/Immune status Age Gender Presentation Evolution before treatment Microbiological HHV-7 diagnosis CSF Primoinfection vs reactivation Specific Treatment Reference
Encephalitis and flaccid paralysis/Immunocompetent 19 Male Severe headache, vomiting, dizziness, and urinary retention Ataxia, impaired pupillary reflexes, reduced level of consciousness, and flaccid paralysis of the lower limbs progressing to quadriparesis HHV-7 DNA in CSF (PCR [12]) and low avidity HHV-7 IgG 65 leucocytes/μl (63 lymphocytes + 2 neutrophils) and 2 red blood cells/μl, elevated protein of 80 mg/dl, and 48,6 mg/dl of glucose (blood glucose 90 mg/dl) P - Ward KN 2002 [6]
Acute myeloradiculopathy/Immunocompetent 26 Male Progressive motor weakness, tingling in the extremities, and dysphasia Cranial nerve involvement and autonomic dysfunctions HHV-7 DNA in CSF by real time-PCR and increase in anti-HHV-7 titers from 1:16 to 1:64 (IFA) Normal at admission with an increase in protein of 89 mg/dl and a modest pleocytosis (8 cells/μl) by day 20. R Intravenous immunoglobulin (400 mg/kg/day) for 5 days Mihara T 2005 [8]
Encephaloradiculomyelitis associated to HHV-7and CMV co-infection/Immunocompetent 51 Male Fever and gradual loss of strength in lower limbs Disorientation and confusion, flaccid paraplegia, urinary retention, and constipation HHV-7 DNA in CSF (nested PCR)a and anti-HHV-7 IgG but not IgM in serum (IFA) Pleocytosis (250 cells/μl) with 93% lymphocytes, 10 red blood cells/μl, high protein levels (950 mg/dl) and normal glucose. R Ganciclovir and dexamethasone Ginanneschi F 2007 [9]
Acute myelitis/Immunocompetent 34 Male Fever, urinary retention, and weakness in the lower limbs - HHV-7 RNA in CSF (PCR-Microarray, Entherpex®, Genomica) 35 leucocytes/μl (predominantly monocytes) elevated protein of 75 mg/dl. - Methylprednisolone (1 g/day) and ganciclovir Miranda M 2011 [10]
Neurological disorder/Immunocompetent 27 Male Persistent headache and fever - HHV-7 RNA in CSF (PCR-Microarray, Entherpex®, Genomica) 160 leucocytes/μl (predominantly monocytes) elevated protein of 75 mg/dl - - Miranda M 2011 [10]
Encephalitis with polymyeloradiculopathy/Immunocompetent 26 Male Headache and fever, dizziness, blurred vision, cervical and lumbar pain, and somnolence Flaccid paralysis of right arm and lower limbs appeared on 5th evolution day HHV-7 DNA in CSF (Multiplex Nested PCR) 110 leucocytes/μl (lymphocytes + monocytes) and 100 red blood cells/μl, elevated protein of 82 mg/dl, and 60 mg/dl of glucose (blood glucose, 108 mg/dl) P or R or PE Intravenous immunoglobulin Ganciclovir Current case
Acute myelitis/Bone marrow recipient 47 Male Pyrexia and urinary retention Spastic paraparesis HHV-7 DNA in CSF (PCR [12]) and high avidity HHV-7 IgG before transplant 48 leucocytes/μl (predominantly lymphocytes), 235 red blood cells/μl, elevated protein of 1.22 g/l, and 52.2 mg/dl of glucose (blood glucose mg/dl 99) R Methylprednisolone (1 g/day) Ward KN 2002 [7]
Acute myelitis/HIV-infected 40 Male Asymmetric paresthesia and hypoesthesia in lower limbs Flaccid paraparesis and severe lower-limb hypoesthesia HHV-7 DNA in CSF (PCR-Microarray, Clart® Entherpex, Genomica) 1 lymphocyte, 0 erythrocytes, 25,88 mg/dl proteins and 59 mg/dl glucose P or R Foscarnet Escobar-Villalba A 2016 [11]
  1. aNested PCR performed on CSF sample was also positive for cytomegalovirus (CMV); IFA, indirect immunofluorescence assay; P: Primoinfection; R: Reactivation; PE: Postinfectious encephalomyelitis