Exanthema subitum is a viral illness caused by human herpes virus 6 (HHV 6) and less commonly by HHV 7. The HHV 6 and HHV 7 are together referred as the Roseolovirus. A disease primarily of childhood, it is also known as roseola, roseola infantum, rose rash of infants, sixth disease, three-day fever and baby measles. The disease initially presents in childhood and the secondary infection is common in immunocompromised individuals.
Exanthema subitum occurs in children less than 2 years of age, with most patients presenting in infancy. After an incubation period of 5-15 days, the classical presentation is that of high-grade fever followed by the appearance of a morbilliform rash.
The fever usually lasts for 3-5 days, with temperatures ranging from 39.5-40.5 degrees celsius  . The baby is usually alert and active without any specific foci of infection . Febrile seizures may be seen in 15% of cases. Lymphadenopathy in the cervical and posterior auricular region may also be seen. Encephalitis and hepatitis are rare manifestations. During this phase, the examination may not reveal a lot of findings. Upper respiratory tract, gastrointestinal and CNS signs are rare at this stage.
The disappearance of fever coincides with the development of a mild morbilliform rash, seen most commonly on the chest and abdomen and rarely, on the face and extremities. The rash may vary in appearance from a small pink papule to a more generalized maculopapular exanthema. The rash usually lasts for a few hours to 2 days and may only be seen in 30% of cases infected with human herpes virus 6 .
Two-thirds of patients may show a characteristic enanthem (Nagayama's spots) on the soft palate and uvula. They usually take the form of erythematous papules and occur most commonly on the 4th day of illness.
HHV-6 often remains latent in patients with a well-functioning immune system. Immunocompromised patients, however, have a more abrupt onset of disease, with the disease spreading to the CNS and other organs  .
Hepatic dysfunction is rarely noted in patients. A few adults, with a past history of HHV-6 infection, may show reactivation of virus with clinical features of mononucleosis . Few patients have been reported with minimal signs and symptoms of the disease despite acquiring HHV-6 infection .
Entire Body System
After an incubation period of 5-15 days, the classical presentation is that of high-grade fever followed by the appearance of a morbilliform rash. The fever usually lasts for 3-5 days, with temperatures ranging from 39.5-40.5 degrees celsius. [symptoma.com]
[…] maculopapular) rash that appears within a few hours to a day after the fever has subsided. [medical-dictionary.thefreedictionary.com]
The convulsions previously thought to be the result of the associated fever of roseola infantum are proably caused by direct infection of the meninges with the HHV6. synonyms Exanthema Subitum, Roseola Infantum, Sixth Disease, Three-Day-Fever Exanthem [dermis.net]
A febrile fever usually last a few minutes and passes on its own without any long term health effects. When is Roseola contagious? The Roseola contagious period is from 2 days before the fever starts until the child is completely fever free. [baby-safety-concerns.com]
[…] very tired, irritable and ill due to the high fever. [1,3,5] Fits Very rarely the rapid rise of fever predisposes the patient to febrile fits. [explainmedicine.com]
[…] translation and definition " exanthema subitum ", English-Polish Dictionary online exanthema subitum Type: noun; a viral disease of infants and young children; characterized by abrupt high fever and mild sore throat; a few days later there is a faint [glosbe.com]
A viral disease of infants and young children with sudden onset of high fever which lasts several days and then suddenly subsides leaving in its wake a fine red rash. [medicine.academic.ru]
Princeton's WordNet (0.00 / 0 votes) Rate this definition: exanthema subitum, roseola infantum, roseola infantilis, pseudorubella (noun) a viral disease of infants and young children; characterized by abrupt high fever and mild sore throat; a few days [definitions.net]
Patient discussion about exanthema subitum Q. roseola high fever A. roseola; any rose colored eruption of the skin--roseola is a viral infection of young children producing a fever which last three or four days after which temperatures drops to normal [medical-dictionary.thefreedictionary.com]
Without any treatment, they may fade within a few hours or persist for as long as 2-3 days. [1,2,3] At risk population Exanthema subitum typically occurs in children between six months and two years of age who present with high fever. [1,3,5] [explainmedicine.com]
Fever Followed by a Rash
followed by a rash. [merckmanuals.com]
Roseola is an acute disease of infants and young children that is characterized by high fever followed by a rash that appears on trunk, limbs, neck and face. A thermometer is a useful aid used to measure body temperature. [mountsinai.org]
Roseola infantum (or roseola) is an infection that can cause a high fever followed by a rash. It usually occurs in babies and children between 6 months and 2 years. It lasts about 3 to 5 days and can make your child feel feverish and unwell. [healthdirect.gov.au]
Roseola is a mild viral illness with a fever followed by a rash. Before the 20th century, children with roseola were lumped in with those with measles or rubella or scarlet fever. [drgreene.com]
Irritability, malaise and runny nose may be present at this time. A red throat with small lesions on the palate and tonsils and swollen lymph glands may be the only other significant symptoms. [southernnevadahealthdistrict.org]
a white female aged 31, was first seen on February 3, 1937, complaining of general malaise and weakness of one day's duration. [annals.org]
However, children may also have malaise, conjunctivitis, orbital edema, inflammation of the tympanic membranes, lymphadenopathy, irritability, anorexia, a bulging fontanelle, diarrhea, cough and other upper respiratory tract symptoms. [ncbi.nlm.nih.gov]
Secondary bacterial infections of the lesions can result in scarring. return to top Fifth Disease: Pruritus, low-grade fever, malaise, and sore throat precede the rash in approximately 10% of cases. Lymphadenopathy is absent. [atsu.edu]
Acutely Ill Patient
CiHHV-6 can be confirmed in acutely ill patients by performing PCR on hair follicle or fingernail samples where active HHV-6 replication is not present (Endo et al. 2014 ; Hall et al. 2010 ; Montoya et al. 2012 ; Ward et al. 2006 ), although their plasma [doi.org]
To evaluate the role of HHV-6 as the causal agent in clinically diagnosed exanthema subitum, we tested for HHV-6 antibody in 57 infants with clinical exanthema subitum and exanthema subitum-like rash without fever. [ncbi.nlm.nih.gov]
Exanthema subitum occurs in children less than 2 years of age, with most patients presenting in infancy. [symptoma.com]
1 Roseola Infantum (Exanthema Subitum, Sixth Disease) ( 28846307 ) 2017 2 Roseola infantum and its causal human herpesviruses. ( 24673253 ) Stone RC...Schwartz RA 2014 3 Detection of human herpesvirus 7 infection in young children presenting with exanthema [malacards.org]
Look at other dictionaries: Exanthema subitum — Klassifikation nach ICD 10 B08.2 Exanthema subitum (Sechste Krankheit) … Deutsch Wikipedia exanthema subitum — noun a viral disease of infants and young children; characterized by abrupt high fever and mild [medicine.academic.ru]
Due to the high fever and the ability of the virus to cross the blood-brain barrier, 15% of children will also experience an acute febrile seizure during the febrile phase of the illness. [ncbi.nlm.nih.gov]
Febrile seizures may be seen in 15% of cases. Lymphadenopathy in the cervical and posterior auricular region may also be seen. Encephalitis and hepatitis are rare manifestations. During this phase, the examination may not reveal a lot of findings. [symptoma.com]
In case of febrile seizures, medical advice can be sought for reassurance. However, febrile seizures are not harmful, do not require treatment, and have no long term negative effects unless they last longer than five minutes. [en.wikipedia.org]
The most common complication is febrile seizures/convulsions that may occur in 5–15% of children. These are triggered by the high fevers of roseola and may be alarming when seen for the first time. [dermnetnz.org]
The diagnosis is usually clinical and a high degree of suspicion is to be held in children from 6 months-3 years with the classical clinical presentation. Further tests are rarely required. Confirmation of diagnosis may be done through serology or culture.
Routine blood tests, including a CBC, blood culture, cerebrospinal fluid (CSF) studies and urinalysis, may be done to rule out other causes of fever . Further testing to exclude other etiologies of seizures may be necessary for some patients.
Serological tests for herpes virus include virus isolation studies and detection of viral DNA from mononuclear blood cells. Antibodies to the different variants of human herpes virus 6 (HHV6A and HHV6B) may be detected by an immunoblot assay .
Histology of affected organs shows a characteristic ballooning of cells.
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