Clinical features and viral excretion in an infant with primary human herpesvirus 7 infection.
Clinical features and viral excretion in an infant with primary human herpesvirus 7 infection.
复制标题
原发性人类疱疹病毒 7 型感染婴儿的临床特征和病毒排泄。
作者：
Y. Asano;S. Suga;T. Yoshikawa;T. Yazaki;T. Uchikawa
目的
目的探讨1例经病毒学确诊的原发性人类疱疹病毒7型（HHV-7）感染患者的临床特征及HHV-7与HHV-6分泌病毒的关系。
患者和方法
一名13个月大的男孩，在6个月大时有已知的皮下皮疹病史，发热3天，在发热消退时出现皮疹。病程中伴有厌食、烦躁、轻度腹泻、眼睑水肿、咽部轻度炎症、枕颈部轻度淋巴结肿大等非特异性体征和症状。肝素化血液样本用于分离HHV-6和HHV-7，并通过巢式聚合酶链反应（PCR）扩增检测两种病毒DNA序列。来自其他身体部位的样本也使用PCR对其DNA序列进行了测试。两种病毒抗体活性均通过间接免疫荧光试验或中和试验测定。
结果
培养的单核细胞从病人在急性期的疾病产生的形态学变化，这只与单克隆抗体HHV-7，但不与抗体HHV-6。两种病毒均未从恢复期获得的血液中分离出来。患者的抗体应答表明对HHV-7的血清转化，但对其他微生物病原体（包括HHV-6和肺炎支原体）的血清转化不存在。在急性期和恢复期外周血单个核细胞中检测到两种病毒DNA序列。HHV-7 DNA经唾液排出，恢复期早期经粪便排出，随后经唾液排出HHV-6。无HHV-7和HHV-6经尿液排泄。
结论
经病毒学证实的原发性HHV-7感染患者的临床特征与原发性HHV-6感染患者相似，HHV-7感染可能重新激活HHV-6。
OBJECTIVE
To find clinical features of a virologically-confirmed patient with primary human herpesvirus 7 (HHV-7) infection and a relationship of the excretion of viruses between HHV-7 and human herpes-virus 6 (HHV-6).
PATIENT AND METHODS
A 13-month-old boy who had a known prior history of exanthem subitum at 6 months of age developed fever for 3 days and a skin rash appeared as the fever was resolving. The course was accompanying with nonspecific signs and symptoms such as anorexia, irritability, mild diarrhea, palpebral edema, mild inflammation of pharynx, and mild occipital and cervical lymphadenopathy. Heparinized blood samples were used for isolation of HHV-6 and HHV-7 and detection of both virus DNA sequences by a nested polymerase chain reaction (PCR) amplification. Samples from other body sites were also tested for their DNA sequences using the PCR. Both virus antibody activity was measured by an indirect immunofluorescent assay or a neutralization test.
RESULTS
Cultured mononuclear cells from the patient at the acute stage of the disease produced morphologic changes, which reacted only with the monoclonal antibody to HHV-7 but not with the antibody to HHV-6. Both viruses were not isolated from blood obtained at the convalescent stage. An antibody response of the patient indicated a seroconversion to HHV-7 but not to other microbial agents including HHV-6 and Mycoplasma pneumoniae. Both virus DNA sequences were detected in peripheral blood mononuclear cells at acute and convalescent stages. HHV-7 DNA was excreted into saliva and transiently into stool at an early convalescent stage followed by HHV-6 excretion into saliva. No HHV-7 and HHV-6 was excreted into urine.
CONCLUSIONS
Clinical features of a virologically confirmed patient with primary HHV-7 infection were comparable with those of primary HHV-6 infection and HHV-7 infection may reactivate HHV-6.