Emerging shadows: HHV-8-associated encephalitis unveiled in a solid organ transplant recipient

Transpl Infect Dis. 2024 Aug;26(4):e14343. doi: 10.1111/tid.14343. Epub 2024 Jul 16.

Abstract

Human herpesviruses (HHVs) cause a wide variety of central nervous system (CNS) infections including meningitis and encephalitis. While HHV-8 is not typically associated with neurological diseases, several studies have indicated a relationship, such as secondary central nervous system (CNS) metastases and a few isolated cases of HHV-8 encephalitis in acquired immunodeficiency syndrome (HIV). However, it has not been previously linked to encephalitis in solid organ transplantation (SOT). This case presents the first-ever instance of HHV-8 encephalitis in a SOT recipient. Our case highlights the association of HHV-8-related diseases, such as post-transplant Kaposi's Sarcoma (KS), with encephalitis. The patient was diagnosed with KS before developing neurological symptoms and received a prompt clinical response through intravenous foscarnet and ganciclovir treatment for 14 days. It is important to note that HHV-8 is a rare cause of encephalitis, and diagnosis requires a high index of suspicion in the appropriate clinical context, allowing for the use of antiviral therapy. This case also underscores the importance of considering the possibility of HHV-8-related diseases in SOT recipients, as they are at risk of developing such infections.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents* / therapeutic use
  • Encephalitis, Viral* / diagnosis
  • Encephalitis, Viral* / drug therapy
  • Encephalitis, Viral* / virology
  • Foscarnet / therapeutic use
  • Ganciclovir* / therapeutic use
  • Herpesviridae Infections* / complications
  • Herpesviridae Infections* / diagnosis
  • Herpesviridae Infections* / virology
  • Herpesvirus 8, Human* / isolation & purification
  • Humans
  • Organ Transplantation / adverse effects
  • Sarcoma, Kaposi* / virology
  • Transplant Recipients

Substances

  • Antiviral Agents
  • Foscarnet
  • Ganciclovir