NON-BACTERIAL POST-TRAUMATIC MENINGITIS DUE TO HUMAN HERPESVIRUS-6 IN AN IMMUNOCOMPETENT PATIENT

Background:Human herpesvirus 6(HHV 6) is a ubiquitous β herpesvirus with seroprevalence up to 90% in adults.While recognised in immune compromised patients and children, symptomatic neuro-meningeal infection in immunocompetent adults is exceptional. Post-traumatic central nervous system (CNS) infections are usually bacterial, and viral meningitis in this setting is extremely rare.

Results: After initial neurological improvement, the patient developed fever and somnolence on day ten. Cerebral CT showed no new lesions. Lumbar puncture revealed haemorrhagic CSF with pleocytosis and hyperproteinorrachia.Multiplex PCR identified HHV 6 DNA exclusively in CSF, while bacterial cultures and other viral tests were negative. In the absence of ganciclovir or foscarnet, intravenous acyclovir was initiated, resulting in rapid clinical improvement and defervescence within 48 hours.

Conclusion:HHV6 meningitis in an immunocompetent adult following traumatic brain injury is exceptionally rare. Clinicians should consider viral etiologies in secondary neurological deterioration. Early lumbar puncture, multiplex PCR, and pragmatic antiviral therapy may aid diagnosis and improve outcomes, even in resource-limited settings.