Human herpesvirus 6 (HHV-6) manifesting as a central nervous system (CNS) infection (especially meningoencephalitis) is reported as a primary infection in children and from reactivation in immunocompromised patients; however, it has rarely been reported in immunocompetent adults. Latent infections of the CNS can cause a myriad of clinical presentations ranging from a benign, febrile, selfresolving illness to limbic encephalitis, temporal lobe seizures, and neuropsychiatric symptoms such as behavioral disturbances and psychosis. No standard diagnostic criteria or management guidelines exist for this condition. Possible neuroimaging findings include abnormalities in the medial temporal lobe involving the hippocampus and amygdala. We hereby present a case of HHV-6 meningitis in a 48-year-old immunocompetent male presenting without encephalopathic symptoms and normal neuroimaging findings.

Metoprolol, an antihypertensive drug belonging to the class β 1 receptor blocker inhibits adrenergic receptors in heart muscle cells and decreases heart rate, contractility and cardiac output thereby decreases the blood pressure. Though, the drug have been approved for the treatment of blood pressure and arrhythmias, the safety profile of it is not yet established in a broader sense. A patient with known hypertensive diagnosis and presenting complaints of bilateral swelling over lower limbs since 15 days and skin lesions over the body since 5 days was admitted to the medicine ward of a tertiary care hospital. After careful evaluation of the patient, the skin lesion was found to be chronic plaque psoriasis of a drug induced nature, which was then treated symptomatically. The suspected drug metoprolol was discontinued. A Naranjo causality assessment of the observed reaction reveals a "probable" causal relationship and rated under "moderate" severe adverse reaction category as per Hartwig's severity assessment.