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Exanthema subitum B08.20

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 03.09.2023

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Synonym(s)

Pseudorubella; Roseola infantum; Rose rash of infants; sixth disease; Three-day fever

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History This section has been translated automatically.

Meigs and Pepper, 1870; Zahorsky, 1910

Definition This section has been translated automatically.

Sporadically occurring, aerosol-spreading, characteristically lasting for 3 days ("three-day fever"), highly febrile, virus-induced "childhood disease" (HHV-6 (occasionally also HHV-7), a DNA virus from the herpes family) with permanent immunity.

Pathogen This section has been translated automatically.

Human DNA virus from the herpes family (HHV-6 and 25% by HHV-7). S.u. Herpes viruses, human.

Manifestation This section has been translated automatically.

Occurs in 95% of cases in the 6th month to 3 years before age; rarely in adulthood.

Clinic This section has been translated automatically.

Incubation period: 3-7 days. Onset with lassitude, fatigue, possibly mild or moderate sore throat; sudden (subitum) rise in fever to 39-40 °C, critical fall after 3 days.

Volatile pinkish exanthema, progressing centrifugally from the trunk to the extremities, usually excluding the face, rubeoliform or morbilloid. Lymphadenopathy

Occasional papular enanthem around the uvula and soft palate (so-called "Nagayama spots").

In adults, analogous exanthema with lymphadenopathy.

In adults, the primary infection is accompanied by a highly febrile clinical picture with maculo-papular exanthema, gastroenteritis, lymphadenopathy, and possible complicating hepatitis and meningoencephalitis.

Laboratory This section has been translated automatically.

Leukocytopenia, lymphocytosis, monocytosis. Detection of HHV-6 IgM and IgG antibodies.

Histology This section has been translated automatically.

Relatively unspecific picture with a discrete, lymphocytic superficial dermatitis, discrete or also distinct erythrocyte extravasations, focal exocytosis.

Differential diagnosis This section has been translated automatically.

Measles; infectious mononucleosis; influenza; scarlet fever; erythema infectiosum; coxsackievirus infection.

Complication(s)(associated diseases This section has been translated automatically.

Fulminant concomitant hepatitis and meningoencephalitis may occur (apparently more frequently in the rare primary infection in adulthood than in childhood).

External therapy This section has been translated automatically.

Symptomatic with shaking mixtures.

Internal therapy This section has been translated automatically.

Antipyretic measures such as paracetamol in age-appropriate dosages.

Literature This section has been translated automatically.

  1. Fried I et al (2009) HHV-6 infection - not always a three-day fever. SDDG 7: 234-236
  2. Meigs JF, Pepper W (1870) A practical treatise of the diseases of children. Lindsay and Blakiston, Philadelphia, pp. 701-703 and 803-806
  3. Zahorsky J (1910) Roseola infantilitis. Pediatrics 22: 60-64
  4. Zahorsky J (1913) Roseola infantum. JAMA 61: 1446-1450

Authors

Last updated on: 03.09.2023

Author: Prof. Dr. med. Peter Altmeyer