case_images: PMC10407201_01
case_images: Liver histology showing (A) inflammatory infiltration of portal tract (H&E, x100); (B) portal tract with plasma cells, eosinophils, and lymphocytes with biliary injury (H&E, x40); and (C) central vein endotheliitis (H&E, x40). H&E, hematoxylin and eosin.
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case_images: A 19-year-old female with a past medical history of acute liver failure secondary to autoimmune hepatitis (status post orthotopic liver transplantation complicated by biliary stricture and recurrent episodes of acute cellular rejection; Fig. 1) presented to the hospital after being found down and unresponsive.
case_images: Magnetic resonance imaging T2 fluid attenuated inversion recovery sequence images of the brain. (A) Sagittal view illustrating multifocal areas of hyperintensity consistent with viral encephalitis in both the right (top row) and left (bottom row) brain. (B) Axial view illustrating multifocal areas of hyperintensity consistent with viral encephalitis in the bilateral frontal and occipital lobes with cerebellar sparing.
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case_images: Magnetic resonance imaging (MRI) of the brain showed areas of cortical and subcortical T2 hyperintensity with peripheral restricted diffusion and lesions involving the frontal, parietal, and occipital lobes (Fig. 2).
case_images: Serum HHV-6 viral load over time. The x-axis indicates the days after admission. The points show the copies of HHV-6 per mL of serum.
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case_images: The HHV-6A viral load continued to decrease during the remainder of the patient's hospital stay from 133,000 copies to 34,000 copies at the time of discharge (Fig. 3).