Encephalopathy associated with human herpesvirus 6 in a liver transplant recipient

Recent reports have documented human herpesvirus 6 (HHV-6) as a cause of hi gh fever, bone marrow depression, and rash in liver transplant recipients i n the absence of another known pathogen. We describe a 49-year-old liver tr ansplant recipient who developed confusion, occipital headache, and involun tary movements of the limbs 3 weeks after orthotopic liver transplantation. HHV-6 was detected, in the, peripheral blood using a rapid culture assay. Examination of cerebrospinal fluid by polymerase chain reaction for HHV-6 w as also positive. No other pathogens were identified. The patient improved after commencement of intravenous ganciclovir therapy. This case suggests H HV-6 needs to be considered in the differential diagnosis of unexplained co nfusion in liver transplant recipients. Copyright (C) 1999 by the American Association for the Study of Liver Diseases.