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Human herpesvirus 7 encephalitis and lack of efficacy: case report A 69-year-old woman developed human herpesvirus-7 (HHV-7) encephalitis during treatment with prednisone and leflunomide for rheumatoid arthritis. Additionally, she exhibited a lack of efficacy during treatment with foscarnet for HHV-7 encephalitis [dosages, routes, duration of treatments to reaction onset not stated]. The woman, who had been receiving prednisone and leflunomide for rheumatoid arthritis (positive centromeric pattern) presented with two generalised tonic-clonic seizure, followed by sensitive aphasia, psychomotor restlessness and inattention. She was also receiving acenocoumarol for deep vein thrombosis. Her medical history was significant for morbid obesity and hypertension. At the time of presentation, her EEG revealed left frontotemporal epileptic activity. Hence, the woman was treated with lacosamide, valproic acid, carbamazepine, clobazam and levetiracetam. Her brain MRI revealed left frontoparietal cortex enhancements, which was compatible with meningoencephalitis in diffusion sequence. Cerebrospinal fluid (CSF) examination revealed 88 leukocytes/mm3 with 96.3 mg/dL proteins. She then received empirical treatment with aciclovir and ampicillin, which was later changed to foscarnet after CRP in CSF resulted in HHV-7 encephalitis. She had a torpid evolution despite of foscarnet treatment and died after 19 days [immediate cause of death not stated]. Gonzalez Martinez A, et al. Severe human herpesvirus 7 (HHV-7) encephalitis in a patient with rheumatoid arthritis. European Journal of Neurology 27 (Suppl. 1): 992 (plus 803498424 poster) abstr. EPO2363, May 2020 [abstract]

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Reactions 29 Aug 2020 No. 1819