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6th Edition of World Congress on Infectious Diseases

June 24-26, 2024 | Paris, France

June 24 -26, 2024 | Paris, France
Infection 2024

Ahmed Esam Mahboub

Speaker at Infectious Diseases Conference - Ahmed Esam Mahboub
Tawam Hospital, United Arab Emirates
Title : HHV6 encephalitis in an immunocompetent host


Introduction: A previously healthy and a fully vaccinated 5-year-old pre-schooler-aged male who presented to the ER with an insidious onset of decreasing level of consciousness and headaches before developing Status Epilepticus, and requiring admission to the PICU; with a final diagnosis of HHV6 Encephalitis based on the BioFire CSF testing.

HHV6 is known to cause CNS infections in immunocompromised individuals, particularly oncology patients; thus, its diagnosis in a previously healthy and an immunocompetent host sheds light on the suspicion, diagnosis, and treatment options for the aforementioned individuals.

Case Description: Presented was initially seen on the same day of the symptoms’ onset in a PHC, where he was prescribed Augmentin treating a throat infection.

Throughout the illness's course, he was becoming progressively more tired, confused, had developed decreasing eye-to-eye contact, and sleepiness.

He was later referred to our facility for further evaluation, when he started to have convulsions, and later on, Status Epilepticus.

Subsequently, he was transferred to the PICU, loaded with Phenytoin, and started on Midazolam IV.

A Brain MRI showed diffuse cortical/deep cortical changes along with DWI restriction and ADC changes, and was suggestive of Hypoxic-Ischemic changes

His initial CSF studies (analysis, culture, and viral panel were normal); however, based on his greatly worrying symptom progression, repeated CSF samples were taken, which came to be positive for HHV6.

He was started on Foscarnet and Ganciclovir; and started to show great improvement and return to his neurological baseline, with a repeated CSF study being negative for the virus.

Followed later on in the clinic, where he was on Keppra prophylaxis and on regular follow-up with Occupational Therapy and Speech-Language Pathology.

Discussion: Viral encephalitis is a medical emergency. It is an aseptic inflammatory process of the brain parenchyma associated with clinical evidence of brain dysfunction, significant morbidity, and mortality (Michael and Solomon 2012).

HHV6 is usually associated with Roseola, which manifests with high fever, URTI symptoms and the development of a rash after the fever subsides.

In immunocompromised patients (haematological malignancies and transplantation), reactivation of roseoloviruses may cause severe, lethal organ dysfunctions, including damage to the limbic system, brain stem, and hippocampus; thus, it could potentially lead to life-long disability.

Moreover, an HHV6 infection may lead to a chromosomally integrated human herpesvirus 6 status, in which the HHV-6 genome is integrated into the host’s genome and is vertically transmitted in a Mendelian manner; that itself may cast doubt on the recently utilized BioFire technology as it could lead to misdiagnose the causation of the illness, and the unnecessary initiation of antiviral therapy that requires strict monitoring and might lead to serious side effects.

The main purpose of presenting the case is to highlight the unique presentation of HHV6 Encephalitis in an immunocompetent host, and to discuss the challenges associated with suspecting the diagnosis, reliability of testing for the infection with a recently utilized technology, and the decision to proceed for, and types of management.


Dr. Ahmed Mahboub is a dedicated Pediatric Resident and Chief of Interns and External Learners at Tawam Hospital in Al Ain, United Arab Emirates. He graduated from United Arab Emirates University's College of Medicine & Health Sciences (CMHS) in Al Ain, where he obtained his medical degree in 2019.

After completing his primary medical education, Dr. Mahboub pursued an internship at Tawam Hospital, where he gained valuable clinical experience and developed a deep understanding of patient care. He then went on to specialize in Pediatrics and is currently in the residency program at Tawam Hospital, where he continues to enhance his skills and knowledge in the field.

Dr. Mahboub is passionate about providing personalized and holistic care to the pediatric community. He firmly believes in the significance of nurturing and supporting the well-being of children as they are the future generations of humanity. Through his dedication, he strives to make a positive impact on the lives of his young patients and their families.

In addition to his medical pursuits, Dr. Mahboub has diverse interests outside of medicine. He is an avid writer of poetry in both Arabic and English, allowing him to express his creativity and emotional depth. He also keeps himself updated on the latest developments in Information Technology, Artificial Intelligence, and Virtual Reality, recognizing their potential to revolutionize healthcare and improve patient outcomes. Furthermore, Dr. Mahboub takes pleasure in the art of hospitality, appreciating the importance of creating a warm and welcoming environment for patients and their families.

Looking ahead, Dr. Ahmed Mahboub has ambitious goals for his career. He aspires to pursue a fellowship in Pediatric Infectious Disease, aiming to specialize further in this critical area of pediatric medicine. By acquiring specialized knowledge and expertise, he aims to contribute to the field and make a significant impact on the prevention, diagnosis, and treatment of infectious diseases in children.

Dr. Ahmed Mahboub's commitment to pediatric care, his pursuit of knowledge, and his diverse interests make him a valuable asset to the medical community. His dedication to providing holistic care, combined with his passion for innovation and personal interests, sets him apart as a well-rounded and compassionate healthcare professional.