About exanthema subitum in children

V.S. Androukh

Abstract


The article describes etiopathogenesis, clinical picture, diagnosis, management and prognosis of exanthema subitum (ES). The disease occurs in nearly all infants and is not well-known in the general medical community. Exanthema subitum in children, mostly aged 6 months to 2 years, is caused by herpes viruses (HSV-6, HSV-7), which are aerosol-transmissible and communicable, and is characterized by hyperthermiс syndrome and rash. Hyperthermic syndrome (≥ 39 °C) lasts for about 3 days. On day 4 of disease, body temperature normalizes, but blotchy rash appears, mainly on the trunk. It also lasts for 3 days, sometimes resulting in erythema. The disease must be differentiated with other states, from tooth eruption in a child and to the onset of acute meningococcal infection. Fever of unknown etiology, rubella, measles, scarlet fever, fifth disease, enteroviral enantemа, toxemia and allergic rashes, pneumonia, pyelonephritis, otitis media my have the same manifestations as ES. There are a number of laboratory methods for verifying the disease, but enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction are being used most often. For the treatment in febrile period, non-steroidal anti-inflammatory drugs should be administered. Symptomatic treatment is also indicated. There are few clinical data on the use of antiviral drugs such as ganciclovir, foscarnet, cidofovir, their effectiveness is controversial. The main criteria for the diagnosis of ES are: age from 6 months to 2 years; sudden onset with fever ≥ 39 °C or higher during 3–4 days at a relatively satisfactory general condition; the appearance of exanthema from the 4th day of illness, mostly on the trunk, against the normalization of body temperature; in most cases has a favorable course and does not require special treatment. However, it may be a mask of other, much more serious diseases and complications, and therefore requires careful medical supervision of a sick child.

Keywords


exanthema subitum; etiopathogenesis; clinical picture; management; prognosis; children

References


Abaturov AYe, Shostakovich-Koretskaia LR. HHV-6-infection in children. Zdorovʹe rebenka. 2007;3(6):70-80. (in Russian).

Katilov AV, Bulat LM, Laiko LI, Lobodiuk AA. Infectious (viral) exanthema in pediatric practice. Dytjachyj likar. 2015;52-53(5-6):15-26. (in Russian).

Vygovs'ka OV. Herpesvirus infections in children: classification, clinical forms, manifestations, social and medical aspects. Dytjachyj likar. 2016;4(49):41-51. (in Ukrainian).

Karazhas NV, Malyshev NA, Rybalkina TN, et al. Gerpeticheskie infektsii: epidemiologiia, klinika, diagnostika, lechenie i profilaktika. Metodicheskie rekomendatsii [Herpetic infections: epidemiology, clinic, diagnostics, treatment and prevention. Guidelines]. Moscow; 2007. (in Russian).

Kuskova TK, Belova EG. Family of herpesviruses at the present stage. Lechashchii vrach. 2004;5:6-11. (in Russian).

Kalugina MYu, Karazhas NV, Rybalkina TN, et al. The importance of diagnosis of infection caused by human herpes virus type 6. Children Infections. 2012;11(1):60-63. (in Russian).

Melehina EV, Chugunova OL, Karazhas NV. Clinical forms of infection caused by the human herpesvirus type 6 in children over one year. In: Pediatriia i detskaia khirurgiia. Sbornik tezisov: Tom 3 [Pediatrics and Pediatric Surgery. Book of Abstracts: Vol 3]. 2012. (in Russian).

Nikolsky MA, Radysh MV. The role of human herpes viruses, type 6 and 7, in the development of febrile seizures in children. Voprosy diagnostiki v pediatrii. 2012;4(4):46-48. (in Russian).

Hager PG, author; Kubanova AA, L'vov AN, editors. Detskaia dermatologiia. Differentsial'naia diagnostika i lechenie u detei i podrostkov [Children dermatology. Differential diagnosis and treatment in children and adolescents]. Moscow: Publishing house Panfilov; Binom Laboratoriia znanii; 2013. 410-427 pp. (in Russian).

Iuldashev MA, Rikhsiev USh, Mun AV. Sudden exanthema in children of early childhood age. Molodoi uchenyi. 2015;18(98):77-80. (in Russian).

Iulish EI. The strategy of human relations and interactions with herpesvirus infections. Zdorovʹe rebenka. 2015;3(63):93-98. (in Russian).

Caserta MT, Hall CB, Schnabel K, et al. Diagnostic Assays for Active Infection with Human Herpesvirus 6 (HHV-6). J Clin Virol. 2010 May;48(1):55-57. doi: 10.1016/j.jcv.2010.02.007.

Flamand L, Komaroff AL, Arbuckle JH, Medveczky PG, Ablashi DV. Review, part 1: Human herpesvirus-6-basic biology, diagnostic testing, and antiviral efficacy. J Med Virol. 2010 Sep;82(9):1560-8. doi: 10.1002/jmv.21839.




DOI: https://doi.org/10.22141/2224-0551.13.1.2018.127071

Refbacks

  • There are currently no refbacks.


Copyright (c) 2018 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru