{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:39:30Z","timestamp":1759538370303,"version":"build-2065373602"},"reference-count":8,"publisher":"SMC Media","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Human herpesvirus 6 (HHV-6) is a ubiquitous virus that commonly infects the paediatric population and establishes latency in the host following primary infection. As in other herpesviruses, HHV-6 may reactivate when the immune system becomes severely compromised, such as after chemotherapy or haematopoietic cell transplantation. We report a case of an 83-year-old male, previously diagnosed with multiple myeloma and treated with lenalidomide plus bortezomib, who was admitted to the internal medicine department with bilateral pulmonary thromboembolism. During his stay, he developed severe respiratory dysfunction and fever. A diagnosis of nosocomial pneumonia was established based on imaging and blood tests. Despite broad-spectrum antibiotic therapy the patient remained febrile with worsening respiratory function and developed an erythematous rash on the face and trunk. The chest CT scan revealed scattered ground-glass opacities bilaterally. Investigations for opportunistic agents (serologies and DNA) were also performed, with positive IgM cytomegalovirus (CMV) antibodies, but negative CMV antigen and DNA quantification, while serum DNA was positive for HHV-6. Antibiotics were discontinued and bronchoalveolar lavage (BAL) was performed with HHV-6 polymerase chain reaction (PCR) testing positive, identifying HHV-6B. Treatment with intravenous ganciclovir led to the resolution of symptoms and hypoxaemia. The patient was discharged and completed 21 days of valganciclovir at home. After one year, the patient remains on chemotherapy without pulmonary sequelae or new HHV-6B reinfection.<\/jats:p>","DOI":"10.12890\/2025_005783","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T14:30:02Z","timestamp":1758033002000},"source":"Crossref","is-referenced-by-count":0,"title":["Uncovering the cause of pneumonia: reactivation of HHV-6B in an immunocompromised patient"],"prefix":"10.12890","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1067-6544","authenticated-orcid":false,"given":"Leonor","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Aveiro, Aveiro, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana","family":"Nogueira","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Aveiro, Aveiro, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Alves","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Aveiro, Aveiro, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipa","family":"Ferreira","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Aveiro, Aveiro, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Fonseca","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Unidade Local de Sa\u00fade da Regi\u00e3o de Aveiro, Aveiro, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"10.12890\/2025_005783_ref1","doi-asserted-by":"crossref","unstructured":"Agut H, Bonnafous P, Gautheret-Dejean A. Update on infections with human herpesviruses 6A, 6B, and 7. Med Mal Infect 2017;47:83\u201391. doi: 10.1016\/j.medmal.2016.09.004","DOI":"10.1016\/j.medmal.2016.09.004"},{"key":"10.12890\/2025_005783_ref2","doi-asserted-by":"crossref","unstructured":"Tesini BL, Epstein LG, Caserta MT. Clinical impact of primary infection with roseoloviruses. Curr Opin Virol 2014;9:91\u201396. doi: 10.1016\/j.coviro.2014.09.013","DOI":"10.1016\/j.coviro.2014.09.013"},{"key":"10.12890\/2025_005783_ref3","doi-asserted-by":"crossref","unstructured":"Nakayama T, Okada F, Ando Y, Honda K, Ogata M, Goto K, et al. A case of pneumonitis and encephalitis associated with human herpesvirus 6 (HHV-6) infection after bone marrow transplantation. Br J Radiol 2010;83:e255\u2013258. doi: 10.1259\/bjr\/19375793","DOI":"10.1259\/bjr\/19375793"},{"key":"10.12890\/2025_005783_ref4","doi-asserted-by":"crossref","unstructured":"Azzi JM, Park D, Abdul-Hay M, Cole K, Cirrone F, Kreditor M, et al. Human herpes virus-6 encephalitis following autologous blood and marrow transplant. Clin Hematol Int 2020;2:32\u201334. doi: 10.2991\/chi.d.191123.001","DOI":"10.2991\/chi.d.191123.001"},{"key":"10.12890\/2025_005783_ref5","doi-asserted-by":"crossref","unstructured":"Kuwahara-Ota S, Chinen Y, Mizuno Y, Takimoto-Shimomura T, Matsumura-Kimoto Y, Tanba K, et al. Human herpesvirus-6 pneumonitis in a patient with follicular lymphoma following immunochemotherapy with rituximab. Infect Drug Resist 2018;11:701\u2013705. doi: 10.2147\/IDR.S163686","DOI":"10.2147\/IDR.S163686"},{"key":"10.12890\/2025_005783_ref6","doi-asserted-by":"crossref","unstructured":"Hill JA, Vande Vusse LK, Xie H, Chung EL, Yeung CCS, Seo S, et al. Human herpesvirus 6B and lower respiratory tract disease after hematopoietic cell transplantation. J Clin Oncol 2019;37:2670\u20132681. doi: 10.1200\/JCO.19.00908","DOI":"10.1200\/JCO.19.00908"},{"key":"10.12890\/2025_005783_ref7","doi-asserted-by":"crossref","unstructured":"Mariotte E, Schnell D, Scieux C, Agbalika F, Legoff J, Ribaud P, et al. Significance of herpesvirus 6 in BAL fluid of hematology patients with acute respiratory failure. Infection 2011;39:225\u2013230. doi: 10.1007\/s15010-011-0114-8","DOI":"10.1007\/s15010-011-0114-8"},{"key":"10.12890\/2025_005783_ref8","doi-asserted-by":"crossref","unstructured":"Ward KN, Hill JA, Hubacek P, de la Camara R, Crocchiolo R, Einsele H, et al. 2017 European Conference on Infections in Leukaemia (ECIL). Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematologic malignancies and after hematopoietic stem cell transplantation. Haematologica 2019;104:2155\u20132163. doi: 10.3324\/haematol.2019.223073","DOI":"10.3324\/haematol.2019.223073"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5783\/4851","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5783\/4852","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5783\/4852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T13:03:00Z","timestamp":1759496580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/5783"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":8,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.12890\/2025_005783","relation":{"has-manifestation":[{"id-type":"other","id":"1-130-5783-g4851","asserted-by":"subject"},{"id-type":"other","id":"1-130-5783-g4852","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-130","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2025,9,16]]}}}