PATIENT: A 33-year-old woman developed progressive trochlear palsy without further neurological disorders. HHV-6 subtype B viremia was found in serological examination. TREATMENT: To prevent necrotizing encephalitis, a dangerous complication of untreated symptomatic acute HHV 6 subtype B infection, intravenous antiviral treatment consisting of initially ganciclovir, then ganciclovir and foscarnet in alternating combination and finally solitary foscarnet was performed. The result was complete eradication of viremia and restitution of the palsy. CONCLUSION: Bearing the risk of necrotizing encephalitis, acute HHV-6 subtype B infection should be taken into consideration as a possible cause for progressive neuroophthalmological disturbances of unknown etiology.
PATIENT: A 33-year-old woman developed progressive trochlear palsy without further neurological disorders. HHV-6 subtype B viremia was found in serological examination. TREATMENT: To prevent necrotizing encephalitis, a dangerous complication of untreated symptomatic acute HHV 6 subtype B infection, intravenous antiviral treatment consisting of initially ganciclovir, then ganciclovir and foscarnet in alternating combination and finally solitary foscarnet was performed. The result was complete eradication of viremia and restitution of the palsy. CONCLUSION: Bearing the risk of necrotizing encephalitis, acute HHV-6 subtype B infection should be taken into consideration as a possible cause for progressive neuroophthalmological disturbances of unknown etiology.