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Case report
HHV-6: an unusual cause of cerebellar ataxia
  1. Emad Abu Sitta1,
  2. Ana Khazan2,
  3. Kelly Luttmann1 and
  4. Jennifer Hanrahan1
  1. 1Department of Infectious Disease, University of Toledo Medical Center, Toledo, Ohio, USA
  2. 2College of Medicine and Life Sciences, Medical School, University of Toledo Medical Center, Toledo, Ohio, USA
  1. Correspondence to Dr Emad Abu Sitta; emademad70{at}


Human herpesvirus 6 (HHV-6) infection is the cause of roseola infantum in children. The reactivation of HHV-6 is associated with multiple clinical syndromes including encephalitis and myelitis, especially in haematopoietic stem cell transplant recipients. However, the virus can cause encephalitis in other immunosuppressed as well as immunocompetent individuals. We report a case of a 70-year-old woman who was immunocompromised secondary to treatment of rheumatoid arthritis with leflunomide and methotrexate. The patient presented with acute ataxia, diplopia and dysarthria. MRI brain showed an enhancing lesion in the midbrain. The diagnosis of HHV-6 encephalitis was made after HHV-6 A DNA was detected in both serum and cerebrospinal fluid. Treatment consisted of a 3-week course of intravenous ganciclovir along with physiotherapy. At a 3-month follow-up, repeat MRI brain showed a decrease in size and oedema of the lesion and the patient’s neurological function was improved.

  • infections
  • immunology
  • brain stem / cerebellum
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  • Contributors EAS: literature review, wrote the manuscript. AK, KL and JH: literature review, edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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