Exanthem Subitum (roseola infantum or sixth disease)

Question 1

What is exanthem sub item (sixth disease) caused by?

Answer 1

Caused by human herpes virus 6 (HHV-6); less frequently human herpes virus 7 (HHV-7)

Question 2

How is it transmitted?

Answer 2

little is known but suspected to be from saliva of infected person and enters the host through the oral, nasal, or conjunctival mucosa

Peak incidence: ages 7–13 months
• Incubation period: 5–15 days, average of 10 days
• Communicability is unknown, but most likely contagious before symptoms appear

Question 3

What are the s/s?

Answer 3

• Prodromal phase: usually asymptomatic but may include upper respiratory signs
• Clinical illness: high fever ranging from 37.9° to 40°C (101–106°F) for 3–5 days; resolves abruptly; rash appears 12–24 hours later, lasting about 1–3 days. Rash is pinkish red, flat or raised spots that blanch when touched

Question 4

How do you manage it?

Answer 4

• Comfort measures, such as antipyretics, antipruritics
• Standard precautions are sufficient in the hospitalized child
• Course is generally benign.
  • In children who are uncomfortable or irritable or have a history of febrile seizures, antipyretics may be warranted

Question 5

What are the complications?

Answer 5

HSV-6 may be responsible for some febrile seizures, encephalitis, and meningoencephalitis (rare)