Human herpesvirus type-6 encephalitis: Exploring neuroimaging correlates

Neonatal seizures and encephalitis are life-threatening diseases in the neonatal period. The present case is a 12-day-old term male infant who presented to the emergency department with fever and recurrent seizures, which three antiseizure medications could control. Following normal results from routine tests and cerebrospinal fluid (CSF) analysis, brain magnetic resonance imaging revealed deep white matter involvement, raising suspicion of viral infection. Viral analysis and multi-virus polymerase chain reaction analysis of CSF were positive for human herpesvirus type 6 (HHV-6), and serum PCR revealed active viral replication. The presented case underscores the importance of considering HHV-6 in the differential diagnosis of neonatal seizures and encephalitis, particularly in the presence of a characteristic viral pattern with white-matter involvement on brain MRI.