Human herpesvirus 6 encephalitis simulating brain metastases in a patient with advanced small-cell lung cancer.
BACKGROUND
The brain is a frequent site of metastases in small-cell lung cancer. Symptoms of cerebral involvement are headache, disorientation, nausea/vomiting and seizures.


METHODS
A man with small-cell lung cancer developed a human herpesvirus 6 (HHV-6) meningoencephalitis with neurological symptoms that simulated brain involvement from the lung cancer. HHV-6 is a T cell lymphotropic virus which may be pathogenic in the immunocompromised host. HHV-6 remains latent after the first infection, and when the immune system is compromised it can reactivate. The treatment of HHV-6 infection is highly specific and the drugs recommended are the two antivirals, ganciclovir or foscarnet.


CONCLUSIONS
In cancer patients neurologic symptoms are usually due to brain metastases. This case shows that in a cancer patient any aspecific neurologic symptom should be carefully evaluated in order to exclude a non-oncologic cause. This statement is particularly true if the therapies for the oncological and neurological diseases are effective.
Dipartimento Oncologia-Ematologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy.
Patrizia
P
Mordenti
Elena
E
Zaffignani
Paolo
P
Immovilli
Elisabetta
E
Nobili
Luigi
L
Cavanna
D000998:Antiviral Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019349:Roseolovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D055752:Small Cell Lung Carcinoma / Q000473:pathology*
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir