ABSTRACT
La principal manifestación clínica del herpesvirus 6 es el exantema súbito (también conocido como roséola o sexta enfermedad) y el síndrome febril. Las manifestaciones en el sistema nervioso central no son infrecuentes en la infección por herpesvirus 6, y su fisiopatología no está esclarecida, pero precisan diagnóstico y tratamiento temprano para evitar secuelas potencialmente graves. Se presenta el caso de una niña inmunocompetente de 2 años con cuadro de encefalitis como complicación de infección por herpesvirus 6. Se destaca la importancia del diagnóstico oportuno a fin de instaurar un adecuado tratamiento y seguimiento para evitar complicaciones secundarias a la afectación del sistema nervioso central.
The main clinical manifestation of human herpesvirus 6 is exanthema subitum (also known as roseola infantum) and febrile syndrome. Central nervous system manifestations are not unusual in herpesvirus 6 infection, and even though the pathophysiology is not clear, they need to be early diagnosed and treated in order to avoid potentially serious damage. We present the case of an immunocompetent 2-year-old girl with encephalitis as a complication of herpesvirus 6 infection. We want to emphasize the significance of an early diagnosis and treatment in order to prevent further complications due to the central nervous system extension.
Subject(s)
Humans , Female , Child, Preschool , Herpesvirus 6, Human/isolation & purification , Encephalitis, Viral/diagnosis , Exanthema Subitum/diagnosis , Encephalitis, Viral/virology , Exanthema Subitum/complicationsABSTRACT
In this study, we assessed the prevalence of human herpesvirus-7 (HHV-7) in 141 serum samples from children less than four years of age with exanthematic disease. All samples were negative for measles, rubella, dengue fever and parvovirus B19 infection. Testing for the presence of human herpesvirus-6 (HHV-6)-specific high avidity IgG antibodies by indirect immunofluorescence assay (IFA) revealed two main groups: one composed of 57 patients with recent primary HHV-6 infection and another group of 68 patients showing signs of past HHV-6 infection. Another 16 samples had indeterminate primary HHV-6 infection, by both IgG IFA and IgM IFA. Serum samples were subjected to a nested polymerase chain reaction to detect the presence of HHV-7 DNA. Among patients with a recent primary HHV-6 infection, HHV-7 DNA was present in 1.7 percent of individuals; however, 5.8 percent of individuals tested positive for HHV-7 DNA in the group with past primary HHV-6 infection. Among the 16 samples with indeterminate diagnosis, 25 percent (4/16) had HHV-7 DNA (p < 0.002). We hypothesise that HHV-7 might be the agent that causes exanthema. However, a relationship between clinical manifestations and the detection of virus DNA does not always exist. Therefore, a careful interpretation is necessary to diagnose a primary infection or a virus-associated disease. In conclusion, we detected HHV-7 DNA in young children from the state of Rio de Janeiro, Brazil.
Subject(s)
Child, Preschool , Humans , DNA, Viral , Exanthema Subitum , Brazil , Exanthema Subitum , Exanthema Subitum , Polymerase Chain Reaction , PrevalenceABSTRACT
Objective To explore the clinical characteristics of roseola infantmn with febrile convulsions.Methods All cases with roseola infantum or with febrile convulsions were retrospectively collected who were confirmed during January 2005 to February 2008. There were 31 cases of roseola infantum with febrile convulsions. Their clinical features were compared with cases of roseola infantum without febrile convulsions and eases of other febrile convulsions,respectively, and further analyzed with literature. Results There were 17.1% (3 1 / 181 ) roseola infantum with febrile convulsions among febrile convulsions and 24.4% (31/127)among febrile convulsions less than 2 years;The incidence of roseola infantum with febrile convulsions was 15.7% (31/198) among roseola infantum. The median age of roseola infantum with febrile convulsions was less than that of other febrile convulsions. There were no significant differences in sex, age, maximum body temperature, duration of fever and day of rash onset between roseola infantum with and without febrile convulsions ( P > 0.05 ), but the frequency of family history of febrile convulsions was significantly higher in roseola infantum with febrile convulsions than in those without febrile convulsions ( P < O. 05). Conclusions Familial predisposition is a risk factor in roseola infantum with febrile convulsions. In most cases the prognosis of roseola infantum with febrile convulsions was good,but it can be associated with severe diseases of central nervous system. Roseola infantum should be considered when encountering children under the age of 1 year with a first febrile convulsion.