Exanthema of viral etiology. Roseola – symptoms in children and adults (high fever, spots on the skin), diagnosis and treatment

– an acute infectious disease of young children caused by herpes virus types 6 and 7, occurring with a temperature reaction and skin rashes. With sudden exanthema, febrile temperature appears successively, then a papular rash on the skin of the torso, face and limbs. Specific methods for diagnosing sudden exanthema are PCR detection of HHV-6 and ELISA for IgM and IgG titers. Treatment of sudden exanthema is mainly symptomatic (antipyretics); antiviral drugs may be prescribed.

Sudden exanthema (pseudo-rubella, roseola, three-day fever, sixth disease) is a childhood viral infection characterized by high fever and a spotty rash on the skin. Sudden exanthema affects about 30% of young children (from 6 months to 3 years). In most cases, sudden exanthema develops in a child between 9 months and 1 year of age; less often up to 5 months. It is assumed that the disease is transmitted by airborne droplets and contact. The peak of the spread of infection occurs in autumn and winter; girls and boys get sick equally. Sudden exanthema is experienced by children once, after which those who have recovered develop stable immunity.

Causes of sudden exanthema

The etiological agents causing sudden exanthema are human herpes viruses types 6 and 7 (HHV-6 and HHV-7). Among these two types, HHV6 is more pathogenic and is considered the main causative agent of sudden exanthema; HHV7 acts as a second pathogen (cofactor).

HHV-6 and HHV-7 belong to the family Herpesviridae, genus Roseolovirus. Viruses have the greatest tropism for T-lymphocytes, monocytes, macrophages, astrocytes, arborescent cells, epithelial tissue, etc. Once in the body, pathogens stimulate the production of cytokines (interleukin-1b and tumor necrosis factor-α), react with cellular and circulating immune complexes , causing the appearance of sudden exanthema.

In adolescents and adults, HHV-6 is associated with asymptomatic urinary infection. In addition, reactivation of a virus that latently persists in the central nervous system can cause the development of meningoencephalitis and myelitis. HHV-6 is reported to be the culprit in benign (lymphadenopathy) and malignant (lymphoma) lymphoproliferative diseases. Some authors associate chronic fatigue syndrome with HHV-7.

Symptoms of sudden exanthema

The incubation period for sudden exanthema ranges from 5 to 15 days. The disease begins with a sudden increase in body temperature to high values ​​(39-40.5°C). The period of fever lasts for 3 days, accompanied by severe intoxication syndrome (weakness, apathy, lack of appetite, nausea).

It is characteristic that with sudden exanthema, despite such a high temperature, in most cases there are no catarrhal symptoms (runny nose, cough). Relatively rarely, younger children experience diarrhea, nasal congestion, enlarged cervical lymph nodes, swelling of the eyelids, hyperemia of the pharynx, and a small rash on the soft palate and uvula. In infants, pulsation of the fontanelle is sometimes observed.

Body temperature decreases slightly in the morning; While taking antipyretics, children feel satisfactory. Since sudden exanthema coincides with teething, parents often explain the increased temperature precisely by this fact. Sometimes, with a sharp increase in temperature to 40°C and above, febrile convulsions develop: with sudden exanthema, they occur in 5-35% of children aged 18 months to 3 years. Febrile seizures are usually not dangerous and go away on their own; they are not associated with damage to the nervous system.

A critical decrease in temperature with sudden exanthema occurs on the 4th day. Normalizing the temperature creates a false impression that the child has completely recovered, but almost simultaneously, a pinpoint or small-spotted pink rash appears all over the body. The rash first appears on the back and abdomen, then quickly spreads to the chest, face and limbs. Elements of the rash with sudden exanthema are roseolous, macular or maculopapular in nature; pink color, diameter up to 1-5 mm; when pressed they turn pale, do not tend to merge and do not itch. The rash that accompanies sudden exanthema is not contagious. During the period of rashes, the child’s general well-being does not suffer. Skin manifestations disappear without a trace after 2-4 days. In some cases, sudden exanthema may occur without a rash, only with a febrile period.

Complications from sudden exanthema develop quite rarely and, mainly, in children with reduced immunity. Cases of the development of acute myocarditis, meningoencephalitis, cranial polyneuritis, reactive hepatitis, intussusception, and post-infectious asthenia have been described. It has been noted that after suffering a sudden exanthema, children may experience accelerated growth of adenoids and frequent colds.

Diagnosis of sudden exanthema

Despite its high prevalence, the diagnosis of sudden exanthema is extremely rarely made in a timely manner. This is facilitated by the transience of the disease: while a diagnostic search is underway, the symptoms of infection, as a rule, disappear on their own. However, children with a high fever or rash should definitely be examined by a pediatrician and a pediatric infectious disease specialist.

In the physical examination, the leading role belongs to the study of the elements of the rash. Sudden exanthema is characterized by the presence of small pink spots that disappear with diascopy, as well as papules with a diameter of 1-5 mm. In side lighting, it is noticeable that the elements of the rash rise slightly above the surface of the skin.

A general blood test reveals leukopenia, relative lymphocytosis, eosinopenia, granulocytopenia (sometimes agranulocytosis). The PCR method is used to detect the virus. To determine the active virus in the blood, a culture method is used. In children who have recovered from sudden exanthema, IgG and IgM to HHV-6 and HHV-7 are detected in the blood using ELISA.

In case of complications of sudden exanthema, consultation with a pediatric neurologist, pediatric cardiologist, pediatric gastroenterologist and additional instrumental studies (EEG, ECG, abdominal ultrasound, etc.) are necessary.

In case of sudden exanthema, differential diagnosis should be carried out with fever of unknown etiology, rubella, measles, scarlet fever, erythema infectiosum, enteroviral infections, allergic rash, drug toxicoderma, pneumonia, pyelonephritis, otitis.

Treatment of sudden exanthema

The contagiousness of the virus is not high, however, children with sudden exanthema should be isolated from their peers until other infectious diseases have been ruled out and symptoms disappear.

In the room where the patient with sudden exanthema is located, daily wet cleaning and ventilation are carried out every 30 minutes. During the febrile period, the child should receive plenty of fluids (teas, compotes and fruit drinks). Walks are allowed after the temperature normalizes.

There is no specific treatment for sudden exanthema. If children do not tolerate high fever, antipyretic drugs (paracetamol or ibuprofen) are indicated. As prescribed by the pediatrician, antiviral and antihistamine drugs can be used for sudden exanthema.

Forecast and prevention of sudden exanthema

In most cases, the course of sudden exanthema is benign. Usually the disease ends with complete restoration of health. A single infection causes the formation of permanent immunity.

There is no vaccine to prevent sudden exanthema. The main preventive measures come down to isolating the sick child and preventing complications.

(Exanthema subitum) or roseola.

This childhood disease is very widespread, almost all children aged about 1 year suffer from it, but surprisingly, most domestic pediatricians do not know about it.
The disease is caused by the human herpes virus type 6, is transmitted once, after which a fairly stable immunity is developed.
Previously, it was believed that this infection is caused by enteroviruses (Coxsackie and ECHO) or adenoviruses.

Mostly children aged from 6 months to 2 years are affected, the most common age being 9-10-11 months.
Symptoms:
The disease begins acutely, with a rise in temperature to 39-40. Usually there are no other symptoms other than fever. Usually the disease coincides with teething, so the temperature is often attributed to the teeth.
The temperature persists for 3 days, usually poorly reduced with the help of antipyretic drugs.
In the first 3 days, it is almost impossible to make a diagnosis, since there are simply no other symptoms other than temperature.

On the 4th day the temperature drops, but a rash appears on the body - on the chest, stomach, back, neck, sometimes on the face - pink, small, sometimes very pale, without itching.
The rash usually lasts 1-2 days, then disappears.
After the rash appears, these 1-2 days the child may be capricious, whiny, and will not get off his hands.

What do domestic pediatricians do?– there are several possible scenarios:

1. This is “rubella”. In fact, the rash associated with rubella is similar, but
Appears on the first day of illness
Not accompanied by high fever
Located mainly on the extremities
Diagnosis of “rubella” in this case often leads to a refusal to vaccinate against rubella; a record of past rubella will appear in the child’s record, and the child will pose a danger to others when he actually gets sick with it.

2. Allergic rash.
In 3 days of high fever, they usually manage to cram a lot of medications into a child, both necessary and unnecessary. Paracetamol, Nurofen, Viferon, Sumamed, Amoxiclav are the undisputed leaders on this list. Very often, on the 3rd day of an “unbreakable” temperature, the pediatrician prescribes antibiotics to the child, and the rash that appears the next day is regarded as an allergy to the drug. Which further leads to an unreasonable refusal to use these antibiotics when really necessary.

3. Special skilled people diagnose pseudotuberculosis, a disease that is very rare in children and proceeds in a completely different way.

What do we have to do:
Treatment for this infection is no different from the treatment of acute respiratory viral infections.
The child must receive sufficient fluids.
If you have a high fever, you can give paracetamol (Panadol, Efferalgan) or ibuprofen (Nurofen).
The child requires observation, since before the rash appears there are no longer any special symptoms, and other, more serious diseases (urinary tract infection, otitis media, for example) can occur with such fever.
The infection does not require specific antiviral treatment.

There are practically no complications with this infection; very rarely there may be febrile convulsions in the first 3 days.

Most children suffer this infection in the form of a simple febrile illness without the appearance of a rash, and most likely this is where the legs of the myth about a temperature of 40 during teething grow.
After an infection, IgG antibodies to type 6 herpes virus are detected in the blood, which is evidence of a previous infection and nothing more. These antibodies are not a sign of “latent” or “persistent” herpes infection

Sudden exanthema

What is sudden exanthema -

Sudden exanthema- an acute viral infection of infants or young children, usually initially manifesting as high fever with no local symptoms and subsequent appearance of a rubella-like rash (maculopapular rash). Sudden exanthema is most common in children between 6 and 24 months of age, with the average age being about 9 months. Less commonly, older children, adolescents and adults may be infected. Sudden exanthema has a number of other names: roseola infantum, pseudorubella, sixth disease, 3-day fever, roseola infantum, exanthema subitum, pseudorubella.. It is officially called sudden exanthema because the rash appears suddenly (immediately after the fever), this disease is usually called sudden skin rash. To distinguish sudden exanthema from other childhood diseases with the presence of skin rashes, it was once called the “sixth disease” (as it usually became the sixth disease in young children and lasted about six days), but this name has been almost forgotten.

What provokes / Causes of Sudden exanthema:

Sudden exanthema is caused by the herpes virus 6 (HHV-6), which was isolated in 1986 from the blood of people suffering from lymphoproliferative diseases. and less commonly, herpes virus 7 (HHV-7). HHV-6 was first discovered by Salahuddin et al. in 1986 in adults with lymphoreticular diseases and those infected with the human immunodeficiency virus (HIV). Two years later, Yamanishi et al. isolated the same virus from the blood of four infants with congenital roseola. Although this new virus was initially found in the B lymphocytes of immunocompromised adult patients, it was subsequently found to have an initial affinity for T lymphocytes, and its original name, human B lymphotropic virus (HBLV), was changed to HHV-6. HHV-6 is a member of the genus Roseolovirus, subfamily beta-Herpesvirus. Like other herpes viruses, HHV-6 has a characteristic electron-dense core and an icosahedral capsid surrounded by an envelope and an outer membrane, home to important glycoproteins and membrane proteins. The major component of the cellular receptor for HHV-6 is CD46, which is present on the surface of all nucleated cells and allows HHV-6 to infect a wide range of cells. The primary target of HHV-6 is the mature CD4+ cell, but the virus can infect natural killer (NK) cells, gamma delta T lymphocytes, monocytes, arborescent cells, astrocytes and a variety of T and B cell lineages, megakaryocytes, epithelial tissue, and others. HHV-6 is represented by two closely related variants: HHV-6A and HHV-6B, which differ in cellular tropism, molecular and biological features, epidemiology and clinical associations. Roseola and other primary HHV-6 infections are caused exclusively by variant B. Cases of primary infection associated with variant A remain to be analyzed. HHV-6A and HHV-6B are most closely related to human herpesvirus type 7 (HHV-7), but have some amino acid similarities to human cytomegalovirus (CMV).

Pathogenesis (what happens?) during Sudden exanthema:

Sudden exanthema spreads from person to person, most often through airborne droplets or contact. Peak incidence is spring and autumn. Acquired HHV-6 infection occurs mainly in infants 6-18 months of age. Almost all children become infected before the age of three and remain immune for life. Most significantly, HHV-6 infection acquired in childhood results in a high rate of seropositivity in adults. In the United States and many other countries, almost all adults are seropositive. The underlying mechanisms of HHV-6 transmission are not well understood. HHV-6 persists after primary infection in blood, respiratory secretions, urine and other physiological secretions. Apparently, the source of infection for infants is adults who are in close contact with them and are carriers of HHV-6; other modes of transmission are also possible. The relative protection of newborns from primary infection as long as maternal antibodies are present indicates that serum antibodies provide protection against HHV-6. The primary infection is characterized by viremia, which stimulates the production of neutralizing antibodies, resulting in cessation of viremia. Specific IgM antibodies appear within the first five days from the onset of clinical symptoms; in the next 1-2 months, IgM decreases and is subsequently undetectable. Specific IgM may be present during reactivation of infection and, as many authors indicate, in small quantities in healthy people. Specific IgG increases during the second and third weeks, with an increase in their avidity thereafter. IgG to HHV-6 persists throughout life, but in lower quantities than in early childhood. Antibody levels may fluctuate after a primary infection, possibly as a result of reactivation of latent virus. A significant increase in the level of antibodies, according to some scientists, is observed in the case of infection with other viruses with similar DNA, for example, HHV-7 and CMV. The observations of some researchers indicate that in children, within several years after the primary infection, a fourfold increase in the IgG titer to HHV-6 may again occur, sometimes due to acute infection with another agent; the possible reactivation of latent HHV-6 cannot be excluded. The literature describes that reinfection with another HHV-6 variant or strain is possible. Cellular immunity is important in controlling primary HHV-6 infection and subsequently maintaining latency. Reactivation of HHV-6 in immunologically compromised patients confirms the importance of cellular immunity. The acute stage of primary infection is associated with increased NK cell activity, possibly through IL-15 and IFN induction. In vitro studies showed a decrease in viral replication under the influence of exogenous IFN. HHV-6 also induces IL-1 and TNF-α, suggesting that HHV-6 may modulate the immune response during primary infection and reactivation by stimulating cytokine production. After the primary infection, the virus persists in a latent state or as a chronic infection with virus production. The components of the immune response important in the control of chronic infection are unknown. Reactivation of latent virus occurs in immunologically compromised patients but can also occur in immunocompetent individuals for unknown reasons. HHV-6 DNA is often found after primary infection in peripheral blood mononuclear cells and secretions of healthy individuals, but the major location of latent HHV-6 infection is unknown. Experimental studies conducted by scientists indicate that HHV-6 latently infects monocytes and macrophages of various tissues, as well as bone marrow stem cells, from which it is subsequently reactivated.

Symptoms of Sudden Exanthema:

The disease is not very contagious; the incubation period of the disease is 9-10 days. Signs and symptoms of HHV-6 (or HHV-7) infection may vary depending on the patient's age. In young children, there is usually a sudden rise in temperature, irritability, enlarged cervical and occipital lymph nodes, runny nose, swelling of the eyelids, diarrhea, a small injection in the pharynx, sometimes exanthema in the form of a small maculopapular rash on the soft palate and uvula (Nagayama's spots), redness and swelling of the conjunctiva of the eyelids. A rash appears within 12 to 24 hours of the fever. Older children who develop an HHV-6 (or HHV-7) infection most often have symptoms such as a high fever for several days , possible runny nose and/or diarrhea. Older children are less likely to develop a rash. The temperature during a fever can be quite high, averaging 39.7 C, but can rise higher to 39.4-41.2 C. Despite the high temperature, the child is usually active The temperature drops critically, usually on the 4th day. Exanthema appears as the temperature drops. Sometimes a rash is observed before the fever decreases, sometimes after the child has had no fever for a day. Rashes of a roseolous, macular or maculopapular nature, pink in color, up to 2-3 mm in diameter, they turn pale when pressed, rarely merge, and are not accompanied by itching. The rash usually appears immediately on the torso with subsequent spread to the neck, face, upper and lower extremities, in some cases they are located mainly on the torso, neck and face. The rash persists for several hours or for 1-3 days, disappears without a trace, sometimes exanthema in the form of erythema is noted. Primary HHV-6 infection in newborns also manifests as sudden exanthema. It can be observed in children in the first three months of life, including newborns; its clinical manifestations are generally similar to those in older children, but are milder. A febrile state without local symptoms is the most common form, but the increase in temperature is usually lower than in older children. According to the literature, a more common manifestation of primary HHV-6 infection are cases of asymptomatic infection, in which HHV-6 DNA is detected in peripheral blood mononuclear cells after birth or in the neonatal period. In some patients, HHV-6 DNA persists in peripheral blood cells for some time, followed by the development of a manifest primary HHV-6 infection. HHV-6 infection is associated with a range of manifestations. Some scientists suggest HHV-6 as the cause of the development of chronic fatigue syndrome, others - multiple sclerosis, multiple organ failure syndrome, pityriasis rosea, hepatitis, viral hemophagocytosis, idiopathic thrombocytopenic purpura, hypersensitivity syndrome to drugs, especially antibacterial ones. However, these data are controversial and require further in-depth study. Complications of sudden exanthema Complications occur with sudden exanthema quite rarely, with the exception of children with a weakened immune system. People with healthy immune systems generally develop lifelong immunity to HHV-6 (or HHV-7).

Diagnosis of sudden exanthema:

Blood test: leukopenia with relative lymphocytosis Serological reactions: detection of IgM, IgG to HHV type 6 (HHV -6) Serum PCR for HHV -6. Differential diagnosis: rubella, measles, erythema infectiosum, enterovirus infection, otitis, meningitis, bacterial pneumonia, drug rash, sepsis.

Treatment of sudden exanthema:

Do I need to see a doctor if my child gets sudden exanthema? Yes, that's a good idea. A child with a fever and rash should not be in contact with other children until seen by a doctor. Once the rash and fever disappear, the child can return to normal activities. Treatment of fever If the temperature does not cause discomfort to the child, then treatment is not necessary. There is no need to wake your child to treat a fever unless directed by the doctor. A child with a fever should be kept comfortable and should not be dressed too warmly. Excessive clothing can cause a fever. Bathing in warm water (29.5 C) can help reduce fever. Never rub alcohol on a child (or adult); Alcohol vapor can cause numerous problems if inhaled. If the child is shivering in the bath, the temperature of the bath water should be increased. High temperature with sudden exanthema can initiate convulsions. Fibrillary seizures are common among children 18 months to 3 years of age. They occur in 5-35% of children with sudden exanthema. Seizures can look very scary, but are usually not dangerous. Fibrillary seizures are not associated with long-term side effects or damage to the nervous system or brain. Anticonvulsants are rarely prescribed for treatment or prevention of fever. What to do if your child has seizures caused by a sudden exanthema fever: - Stay calm and try to calm the child, loosen the clothes around the neck. - Remove sharp objects that could cause harm, turn the child on his side so that saliva can flow out of the mouth. - Place a pillow or rolled-up coat under the baby's head, but do not put anything in the baby's mouth. - Wait for the cramps to pass. Children are often drowsy and may sleep after cramps, which is quite normal. After seizures, you need to see a doctor so that the child is examined. A sudden exanthema rash appears when the elevated temperature (fever) subsides. The rash appears on the neck and torso, especially in the abdomen and back, but may also appear on the arms and legs (limbs). The skin becomes reddish in color and temporarily turns pale when pressed. The rash does not itch or hurt. She's not contagious. The rash goes away in 2-4 days and does not return. The prognosis is favorable.

Prevention of sudden exanthema:

Prevention not developed; It is recommended to isolate the patient until the clinical manifestations of the disease disappear.

Which doctors should you contact if you have sudden exanthema:

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Sudden exanthema occurs in children for various reasons and is accompanied by unpleasant sensations, serious deterioration in health.

In order for the baby to recover as quickly as possible, treatment must be started immediately.

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Concept and characteristics

Sudden exanthema in children - photo:

Sudden exanthema is acute infectious disease.

Occurs in young children. Caused by herpes virus types 6 and 7.

Characterized by skin rashes and fever. The child's temperature rises greatly. In most cases, children 1-3 years old are affected. This pathology is tolerated once During the recovery period, the baby develops a strong immunity to the disease.

The disease is transmitted by contact and airborne droplets. The disease occurs most often in autumn and winter.

Despite the high temperature, patients do not have a cough or runny nose.

What is the causative agent and how is it transmitted?

The causative agent of the disease is herpes viruses type 6 and 7. Belong to the family Herpesviridae, family Roseolovirus. As soon as the pathogen enters the body, it begins to actively act and cause disease. Transmitted by airborne droplets and contact.

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Types and forms

Experts identify several forms of the disease:

1. Lightweight. The rash is not spread over the entire body, the temperature will rise slightly, but will quickly return to normal.
2. Average. The rash covers the entire body, but the temperature does not rise above 38 degrees. The condition can be normalized after taking medications.
3. Heavy. The red spots have a very bright hue and cover the entire body. The temperature rises to 39-40 degrees, without medication the condition cannot be normalized. Fever can be life-threatening for the patient.

The disease is divided into two types: with and without fever. The first type appears high fever and seizures. There are no other symptoms.

The second type can appear without fever, but the wall of the pharynx becomes inflamed, the red spots on the body are very bright and take longer to resolve.

Causes and risk group

The disease occurs for the following reasons:

• penetration of the pathogen into the body. Occurs when contact with the patient;
• disturbances in the functioning of the immune system. If she weakened, the children's body is vulnerable;
• hypothermia. Hypothermia significantly increases the likelihood of illness;
• recently transferred colds. After a cold, a child’s body is weakened, the pathogen easily penetrates it and develops quickly.

The risk group includes children who often suffer from colds and are susceptible to gastrointestinal disorders.

The disease often occurs in children suffering from.

However, any child whose immune system is weakened can get this disease.

Symptoms and clinical picture

The disease is quite easy to identify, as it has pronounced symptoms:

1. Temperature increase. Observed in the first 3-5 days.
2. Rash. Gradually spreads throughout the body. The spots can be either pale or bright.
3. Chills. A child may feel cold even if the room is warm.
4. Inflammation of the back of the throat. This is manifested by hoarseness in the voice, sore throat.
5. Diarrhea. Accompanied by abdominal pain.
6. Swelling of the eyelids. The child's eyelids are slightly swollen. On days 5-8 of illness, swelling disappears.

Signs of the disease also include weakness and decreased performance. The child plays less, feels drowsiness and lethargy. You may have trouble falling asleep.

Diagnostics

To confirm or refute the diagnosis, the following diagnostic methods are used:

1. Inspection patient. First, the child is examined by a specialist who examines the spots on the body.
2. Blood analysis. Needed to detect the virus in the body.
3. Analysis of urine. Helps in establishing a diagnosis.

The above methods are quite sufficient to establish a diagnosis. Typically, viral and enteroviral exanthema is diagnosed at the first visit to the doctor.

Folk remedies

To improve the patient’s condition and eliminate the symptoms of the disease, it is recommended to use chamomile infusion.

To do this, mix a tablespoon of this plant and a glass of boiling water.

The solution is infused for two hours, then filtered. It is consumed in the morning and evening, half a glass.

It is recommended that the child take a bath with decoction of celandine. To do this, mix a tablespoon of the plant and a glass of boiling water. The product is infused for an hour, then filtered and added to the collected water in the bath.

The baby is bathed in the resulting liquid for at least twenty minutes. You need to take this bath 3-4 times a week. It will relieve the child of skin rashes, swelling, and improve overall well-being.

During treatment, the child should be given a lot of liquid: tea, compotes, drinking water. This will help normalize the child’s condition and speed up recovery.

Prognosis and prevention

The disease disappears without a trace in 90% of cases. Complications occur only in children with serious disorders of the immune system. In this case, the rash will last for 2-3 weeks, inflammation of the back of the throat may occur, and a cough may appear.

Even with complications, you can get rid of the disease in three weeks.

If the course of the disease is favorable and without complications You can recover within 5-8 days.

There are no negative consequences after recovery. The child is completely healthy. The disease leaves no trace.

It is not practical to prevent the disease, since it does not appear again. The baby develops a strong immunity to this disease. However, it is recommended to give your baby vitamin complexes from time to time, feed him only healthy foods and avoid hypothermia.

This disease appears suddenly, but goes away quickly with timely treatment. Thanks to the measures taken, the baby will recover quickly.

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Sudden exanthema. What it is? And how dangerous is it for your child? Find out about it in the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Exanthema- a skin rash of a viral nature is a local reaction of the human body to the virus. The nature of the rash may vary depending on the pathogen. Blistering rashes, grouped blisters, spots and papules, and a red rash that looks like lace may form on the patient’s skin.

Causes

The etiology of erythema is diverse; there is an opinion that the cause of the rash may be the action of pathogenetic mechanisms:

• Viruses travel through the bloodstream and enter the tissues of the body, which leads to damage to the skin and the appearance of a rash. This principle is typical for enteroviruses, herpes virus type I, etc.;
• exanthema appears due to the reaction of the immune system to the pathogen. This principle is typical when a rash occurs during rubella.

Rubella, measles, herpes type 6 viruses, Epstein-Barr virus, enterovirus, cytomegalovirus have a characteristic rash in the form of papules and spots on the skin. A blistering rash on the skin is formed by the herpes virus type 1, Coxsackie virus, herpes viruses, which provokes the development of chickenpox and herpes zoster.

Viruses that provoke redness of the skin and papulovesicular rash are provoked by adenoviruses, enteroviruses, and hepatitis viruses types C and B.

Parvovirus B19 manifests itself as a characteristic lace-shaped rash on the skin.

Symptoms of exanthema

Depending on the pathogen, the manifestations of exanthema may differ.

With sudden exanthema, the causative agent of which is herpes viruses type 6 and 7, patients have a fever, irritability, enlarged cervical and occipital lymph nodes, runny nose, swelling of the eyelids, diarrhea, a small injection in the pharynx, sometimes exanthema in the form of a small maculopapular rash on the soft sky. The rash appears when the temperature drops.

The causes of viral exanthema are rubella virus, parvovirus, Epstein-Barr virus, and hepatitis B virus. Characteristic manifestations of viral exanthema: fever, flu-like symptoms, swelling of the lymph nodes, upset stomach, fever, damage to the mucous membranes.

Sudden exanthema caused by herpes viruses 6.7 manifests itself in the form of a sharp increase in body temperature in children, characteristic rashes on the body and causeless diarrhea.

Diagnostics

To diagnose exanthema, it is necessary to carry out the following studies:

1. General blood test: leukopenia with relative lymphocytosis.

2. Serological reactions are aimed at identifying IgM, IgG antibodies to HHV type 6 and serum PCR for HHV -6.

3. Differential diagnosis in order to exclude rubella, enteroviral infections, otitis, meningitis, measles, bacterial pneumonia, sepsis.

Classification

1. Drug exanthema - develops as a result of taking or contact with various drugs. After taking antibiotics, barbiturates, anti-tuberculosis drugs, sulfa drugs.

2. Sudden exanthema - the causative agent of this disease is herpes viruses type 6 and 7. Most often occurs in children aged 2 years and older. The child's temperature rises sharply and diarrhea may occur. After a few days, the rash and all accompanying symptoms disappear on their own.

3. Viral exanthema in most cases occurs in infants. The causative agents are herpes viruses, measles and enteroviruses. The patient has a fever, the rash looks like papules, red spots, or depending on the pathogen.

4. Infantile exanthema occurs in children with measles, rubella and scarlet fever. Children experience indigestion, body temperature rises, and the rashes have a characteristic pinkish tint.

Patient Actions

An in-person examination by a doctor is required.

Treatment of exanthema

The specifics of treatment for exanthema depend on the pathogen. Therapy is symptomatic.

For a viral infection, therapy is prescribed taking into account the patient’s age and the degree of development of the disease. Most often, therapy is aimed at relieving the symptoms of the disease; antiviral drugs are used in tablet form or in the form of ointments. The patient is prescribed bed rest and isolation from the peer group.

For enteroviral and paraviral infections, no special therapy has been developed; treatment is symptomatic in order to alleviate the general condition of the patient.

Complications

Complications are quite rare, with the exception of children with reduced immunity. Subsequently, the patient develops lifelong immunity to HHV-6, HHV-7.

Prevention of exanthema

Prevention methods have not yet been developed. It is recommended to isolate the patient until the clinical manifestations of the disease disappear.