The past five years have seen numerous advances in the field of pediatric
infectious diseases, and many of these have a substantial impact on the practice of
dermatology. We
review some of these advances and discuss their implications on
etiology,
diagnosis,
therapy and
complications of some relatively common conditions. The etiologic agent of exanthum subitum (
roseola infantum) has been clearly implicated as a herpesvirus-6. Although in the classically described situation high
fever in a young
child is followed by defervescence and
rash, two new scenarios have been described associated with this
virus. The first is
fever without
rash and the second is
rash without
fever. The etiologic agent of
erythema infectiosum ("slapped
cheek") has been shown to be a
human parvovirus B19. The
virus has also been associated with aplastic crises (in
hemoglobinopathies),
hydrops fetalis, and a
syndrome of subacute
arthralgias in
women. The etiologic agent in
cat-scratch disease has recently been shown to be a small pleomorphic
bacillus that also can produce
pyogenic granuloma-like lesions in
patients with
acquired immunodeficiency syndrome. The number of cases of
congenital syphilis, particularly in large cities, is increasing tremendously. Many of these
infants have received no
prenatal care because of drug abuse problems in their
parents. Finally, we describe the changing
etiology of
impetigo that is predominantly associated with
Staphylococcus aureus. We further describe the growing resistance to
erythromycin and several new
erythromycin drug-
drug interactions.