Human Herpesvirus 6 Encephalitis in a Patient with a History of Psychotropic Drug Use: A Case Report

Abstract

Human herpesvirus 6 (HHV-6) is a beta-herpesvirus typically associated with asymptomatic infections but can cause severe encephalitis, especially in immunocompromised individuals. This report details a case of HHV-6 encephalitis in an immunocompetent 35-year-old male with recent cocaine use. The patient initially presented with confusion and focal neurological deficits, with MRI showing bihemispheric demyelinating lesions. Acyclovir was initiated as empirical antiviral therapy, resulting in partial improvement. However, the patient was readmitted following discharge due to recurrent neurological symptoms, with MRI findings showing extensive, periventricular white matter lesions consistent with acute disseminated encephalomyelitis (ADEM) secondary to HHV-6. Given the atypical response to the treatment, this case highlights the need for further research on optimal antiviral therapies and the role of psychoactive substance use in neurological infections such as HHV-6 encephalitis.