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At least 19 recordsLinked to original sources
PubMed1991

[The blood picture in exanthema subitum (Zahorsky)/ critical 3-day fever-exanthema in young children].

Exanthema subitum was described in 1910 by John Zahorsky/USA; in 1986 and 1988 the human herpesvirus 6 (HHV 6) was discovered as the causative agent of the disease and serologic tests were established for diagnostics (specific IgM and IgG antibodies). Up to this time the diagnosis was based on the typical clinical course: the prodromal febrile stage (3 days) followed by the onset of a (more or less characteristic) rash closely connected with the normalisation of the body temperature. Usually a typical white blood cell count was described for diagnostics on the first day of exanthema: leukocytopenia with eosino- and granulocytopenia associated with consequent lymphocytosis. We analysed the hematologic data for children with a serologically documented HHV6 infection including exanthema (group 1: n = 9), without exanthema (group 2: n = 11) or with a serologically unexplained febrile rash (group 3: n = 13). In children with exanthematous HHV6 infection (exanthema subitum) granulocytopenia and a decreased thrombocyte count (mean values) is the rule. But the total white blood cell count and the mean values for eosinophils did not differ between the groups studied.

Agranulocytosis↗
PubMed1993

Exanthema subitum and human herpesvirus 6 infection: clinical observations in fifty-seven cases.

Exanthema subitum had been speculated to be a viral disease although its pathogen is unknown. Human herpesvirus 6 (HHV-6), first isolated in 1986, was proved by Yamanishi et al. to be the causal agent of exanthema subitum. 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. Of the 53 patients with clinical exanthema subitum 43 showed seroconversion or a significant rise in antibody titer to HHV-6, 7 were seropositive without significant rise and 3 remained seronegative. The clinical manifestations of these 43 infants with serologically confirmed HHV-6 infection were consistent with the classical characteristics of exanthema subitum. The 4 patients with atypical exanthema subitum showed significant rises in antibody titer. Our results therefore show that the majority of cases with typical clinical manifestations of exanthema subitum had HHV-6 infection. Most cases with HHV-6 infection had the typical clinical course of exanthema subitum, and a few cases might show an afebrile exanthema subitum-like rash.

Antibodies, Viral↗
PubMed1990

Role of human herpesvirus 6 infection in infants with exanthema subitum.

Twenty-two infants with exanthema subitum and their mothers were studied for human herpesvirus 6 (HHV-6) infection. HHV-6 was isolated from 13 of the 22 infants, in 5 infants by cultivation of their peripheral blood mononuclear cells and in the other 8 infants by cocultivation of their mononuclear cells with those from newborn cord blood. Of the 22 infants 19 showed a 4-fold or greater rise in HHV-6 antibody titers between the acute and convalescent stages of the disease. These findings support the contention that HHV-6 causes exanthema subitum. Attempts at isolation of HHV-6 from the saliva and peripheral blood mononuclear cells of the mothers of 14 of the 22 infants were unsuccessful. Serum samples from 22 mothers were all reactive to HHV-6 antigens, as evidenced by immunofluorescence and radioimmunoprecipitation analyses.

Antibodies, Viral↗
PubMed2006

Time course characteristics of human herpesvirus 6 specific cellular immune response and natural killer cell activity in patients with exanthema subitum.

The time-course of cell-mediated immunity in exanthema subitum is not well documented. The lymphoproliferative response to purified human herpesvirus 6 (HHV-6) antigen and to phytohemagglutinin was measured and natural killer (NK) cell activities determined in three consecutive specimens obtained biweekly from 18 young children and infants with exanthema subitum. Virus isolation and PCR detection of virus DNA and determination of neutralization antibody to HHV-6 and -7 were also carried out. The magnitude of the HHV-6 specific lymphoproliferative response varied; however, in most cases the time course kinetics revealed a low response in the acute phase with a subsequent gradual increase. In contrast, NK cell activities were high in the acute phase and declined gradually during convalescence. The lymphoproliferative response to phytohemagglutinin did not show a consistent trend in kinetics of time; however, dynamic changes in activity were observed in patients during the acute and convalescent periods. The results suggest that NK cells play a major role in resolving acute phase infection while specific lymphocyte activity develops later. The cause of the delayed development of HHV-6 specific lymphoproliferative response is unknown. The lymphoproliferative response to phytohemagglutinin ratios implied that HHV-6 infection has some impact on host T-cell immunity during the course of exanthema subitum.

Cell Proliferation↗
PubMed1989

[The critical 3-day fever-exanthema in young children (exanthema subitum, Zahorsky roseola infantum)--what is new?].

As to the present knowledge the critical rose rash of infants (exanthema subitum, roseola infantum) means to be an exanthematous infectious disease that, occurring preferably in elder babes and younger infants (1st--3rd year of life), is caused by the newly detected herpesvirus (now the sixth one) pathogenic for man. The natural contamination in our latitude is intense (60-75%), and the probably lifelong immunity in the majority of cases is acquired in infancy. Though experts in the clinical subject do stress all the time the exanthema subitum to be the most frequent exanthematous disease in early infancy and infancy, infection chains tested to exanthema, respectively epidemics are observed decidedly seldom. Consequently, most of all infections use to develop clinically inperceptibly or even with other symptoms (and without an exanthema); the exanthema up to now obligatory for establishing the diagnosis uses to appear only in the minority of all cases and in the great majority of them the seroconversion is clinically silent. The prognosis of the exanthema subitum is in force to be good; the disease is the special field of activity for ambulatorily acting physicians (paediatrist, general practitioner). To begin with, the status diagnostically unclear and high-febrile for several days, the central-nervous excitability occurring in many cases, and in some children the appearing of dramatic febrile convulsions, as well as gastroenteric symptoms perpetually give rise to differential diagnostic considerations and sometimes even to a (false) antibiotic therapy. In case of an affection by herpesviruses principally a latency (persistence) of the virus lasting for years (possibly even lasting for life) in human beings is to be taken into account; this condition is also current for HHV 6. On occurring of an immune debility a release and a discharge of herpesviruses--not only by children suffering from an exanthema subitum (!)--are possible so that human beings of each age may come into question to be the source of infection. Double infections of human immune cells (for instance HHV 6 and HIV 1 simultaneously) already have been found. The necessary studies in order to clarify essential clinical and virological problems are world-widely in full activity, and new cognitions (further symptoms of diseases associated with HHV 6, possibly affections in prenatal infections and so on) are soon to be taken into account.

Child, Preschool↗
PubMed1992

Serology versus clinical signs or symptoms and main laboratory findings in the diagnosis of exanthema subitum (roseola infantum).

Twenty-five patients with clinical exanthema subitum (roseola infantum) were enrolled into a study, where acute-phase and convalescent sera were examined for antibodies to human herpesvirus 6 (HHV-6), several other viruses, and other microbes. In addition, an acute-phase fecal specimen was examined for viruses by electron microscopy. Confirmative or suggestive serologic evidence for recent HHV-6 infection was obtained in 23 (92%) cases. Conversion to HHV-6 was found in 19 (76%), a diagnostic (greater than or equal to 4-fold) titer rise in 2, a twofold titer rise in 1, and a stable relatively high titer in 1 of the patients; only 2 (8%) individuals remained negative. The other microbial assays produced only two slight mycoplasma antibody rises and one rotavirus identification in the fecal specimen. It is concluded that if the clinical diagnosis of exanthema subitum is deemed doubtful, HHV-6 infection is verifiable in about 75% of the cases by serology.

Antibodies, Viral↗
PubMed1991

[Seroprevalence of antibodies to human herpesvirus 6 (exanthema subitum; critical 3-day fever-exanthema in young children) in the population of Northern Germany].

We tested 989 sera of all age groups (patients and blood donors) from north eastern Germany (West Pomerania and Mecklenburg) and found 820 cases (82.9%) of specific human herpes virus type 6 (HHV 6) antibodies (IgG) gy indirect immunofluorescent assay. The seroprevalence rose to 83.6% when the 7 HHV 6-IgM positive results (0.7%) were included; moreover a further 23 sera (2.3%) showed specific HHV 6 antibodies of both classes (IgM and IgG). The antibody prevalence was constantly high at 90% from the age of 8 months up to the 71-80 years group, and it only decreased in the age group over 80. 93.2% of the newborn infants showed HHV 6-IgG antibodies (of maternal origin) in the cord blood; this prevalence is identical with that for females of reproductive age (92.7% in the 3rd decade, 93.7% in the 4th decade). No sex differences in seroprevalence were observed. The main immunization occurs in the first year of life but infection with HHV 6 at a later age is also well documented. We found the lowest seroprevalence in the 3rd and 4th postnatal months (when maternal immunity had disappeared); later the seroprevalence of specific antibodies rose very rapidly and by the 8th month the rate was the same as for the adult group. The theoretical possibility of prenatal infection due to HHV 6 exists, but the real risk of a first infection during pregnancy is very low, because only 7-8% are susceptible in this group.

Adolescent↗
PubMed1998

Neuroradiologic findings of brain lesions related to exanthema subitum.

The neuroradiologic findings of the brain lesions in eight infants with exanthema subitum were normal in three, suspected vascular lesions in two, and symmetric thalamic lesions with or without diffuse brain edema in the other three. In addition, diffuse brain edema or focal cerebral lesions were observed in 13 previously reported Japanese infants. These findings suggest that the pathogeneses of the brain lesions related to exanthema subitum are variable.

Brain Diseases↗
PubMed1991

[Exanthema subitum, encephalopathy and hepatitis caused by human herpesvirus type 6 (HHV-6) in a 10-month-old infant].

We describe the unusual clinical course in a case of exanthema subitum with affection of the liver and central nervous system in a 10-months-old girl. HHV-6 infection was confirmed serologically (positive HHV-6 IgM from 10th to 29th day, increasing IgG-titres). At the beginning of the illness convulsions with preference to the right side were noticed, which were consistent with an encephalitis (on top to a suspected pre/perinatal lesion) and resulting in spastic triplegia. Nuclear magnetic resonance imaging and cranial computertomographic results showed severe, predominantly left-sided cerebral lesions. In addition there was clinical and biochemical evidence of an associated hepatitis. Human herpesvirus-6 has been identified as the cause of exanthema subitum. In addition, the virus is known to cause other clinical entities (lymphadenopathy, febril seizures, hepatitis, postinfectious chronic fatigue a.o.) and has been identified in brain tissues. Our observations show that the course of exanthema subitum can be complicated by affection of the liver and central nervous system. At present it is impossible to estimate the clinical outcome in our patient.

Brain Damage, Chronic↗
PubMed1989

[New knowledge of Zahorsky exanthema subitum (critical 3-day fever-exanthema, roseola infantum].

A survey is given on the history, characteristic symptoms and recent data of the etiology of exanthem subitum (Zahorsky's disease, sixth disease, roseola infantum). Some cases are presented and modern diagnostic techniques for atypical cases are discussed. The disease is caused by an infection with the human herpesvirus-6 (HHV 6; syn.:, "human B-lymphotropic virus", HBLV). Most babies and small children have an asymptomatic infection usually leading to lifelong immunity. The typical "exanthem subitum" develops only in a minority of the infected and susceptible persons. We suggest that the novel human herpesvirus-6 also has the potential of lifelong persistence in humans and can then be shedd at any age in case of acquired immunodeficiencies. World-wide research in this field is carried out by several working groups and new data will be available in a few years.

Antibodies, Viral↗
PubMed1992

[Sixth disease--exanthema subitum].

The author deals with the epidemiology of the sixth disease--exanthema subitum which is caused by the herpes virus hominis type 6. There are nine forms of the disease. The haemogram is characterized by granulocytopenia, eosinopenia with relative lymphocytosis, thrombocytopenia.

Exanthema Subitum↗
PubMed2002

Frequent seizures with elevated interleukin-6 at the eruptive stage of exanthema subitum.

A 15-month-old girl developed frequent seizures at the eruptive stage of exanthema subitum. The eruption persisted for 2 weeks. Serum immunoglobulin G antibody to human herpes virus type 6 (HHV-6) increased markedly. Interleukin-6 was elevated whereas HHV-6 deoxyribonucleic acid was not detected in cerebrospinal fluid. These findings suggest that immune-mediated reactions after HHV-6 infection rather than direct action of active HHV-6 are responsible for frequent seizures in this case.

Acute Disease↗
PubMedDate not supplied

[Exanthema subitum].

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Exanthema Subitum↗