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Roseola
Roseola, also known as sixth disease, is an infectious disease caused by certain types of human herpes viruses. Most infections occur before the age of three. Symptoms vary from absent to the classic presentation of a fever of rapid onset followed by a rash. The fever generally lasts for three to five days, while the rash is generally pink and lasts for less than three days. Complications may include febrile seizures, with serious complications being rare.
It is caused by human herpesvirus 6 (HHV-6A, HHV-6B) or human herpesvirus 7 (HHV-7). Spread is usually through the saliva of those who are otherwise healthy. However, it may also spread from the mother to the baby during pregnancy. Diagnosis is typically based on symptoms and does not need to be confirmed with blood tests (PCR or antigen). Low numbers of white blood cells may also be present.
Treatment includes sufficient fluids and medications to treat the fever. Nearly all people are infected at some point. Males and females are affected equally often. The disease may reactivate in those with a weakened immune system and may result in significant health problems.
The disease was first described in 1910 while the causal virus was isolated in 1988. The name "sixth disease" comes from its place on the standard list of rash-causing childhood diseases, which also includes measles (first), scarlet fever (second), rubella (third), Dukes' disease (fourth, but is no longer widely accepted as distinct from scarlet fever), and erythema infectiosum (fifth).
Symptoms begin with a three to six-day febrile illness. During this time, temperatures can peak above 40 °C and children can experience increased irritability with general malaise. Many children in the febrile phase feel well, engaged, and alert. For these patients, fever is usually diagnosed incidentally.
The most common complication (10-15% of children between 6 and 18 months) and most common cause of hospitalization in children with primary infection of HHV-6B is febrile seizures which can precipitate status epilepticus due to the sudden rise in body temperature.
Once the febrile phase subsides, a rash develops. The rash sometimes presents one or two days after the fever resolves. The rash is classically described as an erythematous morbilliform exanthem and presents as a distribution of soft pink, discrete, and slightly raised lesions each with a 2-5mm diameter. It classically begins on the trunk (torso) and spreads outward to the neck, extremities, and face. This pattern is referred to as a centrifugal spread. Usually, peeling and itching are not characteristic of this rash. This phase can last anywhere from several hours to 2 days.
A small percentage of children acquire HHV-6 with few signs or symptoms of the disease. Children with HHV-6 infection can also present with myringitis (inflammation of the tympanic membranes), upper respiratory symptoms, diarrhea, and a bulging fontanelle. In addition, children can experience pharyngitis with lymphoid hyperplasia seen on the soft palate and swelling of the eyelids. These symptoms usually present during the febrile phase of roseola. Cervical and postoccipital lymphadenopathy can also be seen, but this generally presents 2–4 days after the onset of the febrile phase.
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Roseola
Roseola, also known as sixth disease, is an infectious disease caused by certain types of human herpes viruses. Most infections occur before the age of three. Symptoms vary from absent to the classic presentation of a fever of rapid onset followed by a rash. The fever generally lasts for three to five days, while the rash is generally pink and lasts for less than three days. Complications may include febrile seizures, with serious complications being rare.
It is caused by human herpesvirus 6 (HHV-6A, HHV-6B) or human herpesvirus 7 (HHV-7). Spread is usually through the saliva of those who are otherwise healthy. However, it may also spread from the mother to the baby during pregnancy. Diagnosis is typically based on symptoms and does not need to be confirmed with blood tests (PCR or antigen). Low numbers of white blood cells may also be present.
Treatment includes sufficient fluids and medications to treat the fever. Nearly all people are infected at some point. Males and females are affected equally often. The disease may reactivate in those with a weakened immune system and may result in significant health problems.
The disease was first described in 1910 while the causal virus was isolated in 1988. The name "sixth disease" comes from its place on the standard list of rash-causing childhood diseases, which also includes measles (first), scarlet fever (second), rubella (third), Dukes' disease (fourth, but is no longer widely accepted as distinct from scarlet fever), and erythema infectiosum (fifth).
Symptoms begin with a three to six-day febrile illness. During this time, temperatures can peak above 40 °C and children can experience increased irritability with general malaise. Many children in the febrile phase feel well, engaged, and alert. For these patients, fever is usually diagnosed incidentally.
The most common complication (10-15% of children between 6 and 18 months) and most common cause of hospitalization in children with primary infection of HHV-6B is febrile seizures which can precipitate status epilepticus due to the sudden rise in body temperature.
Once the febrile phase subsides, a rash develops. The rash sometimes presents one or two days after the fever resolves. The rash is classically described as an erythematous morbilliform exanthem and presents as a distribution of soft pink, discrete, and slightly raised lesions each with a 2-5mm diameter. It classically begins on the trunk (torso) and spreads outward to the neck, extremities, and face. This pattern is referred to as a centrifugal spread. Usually, peeling and itching are not characteristic of this rash. This phase can last anywhere from several hours to 2 days.
A small percentage of children acquire HHV-6 with few signs or symptoms of the disease. Children with HHV-6 infection can also present with myringitis (inflammation of the tympanic membranes), upper respiratory symptoms, diarrhea, and a bulging fontanelle. In addition, children can experience pharyngitis with lymphoid hyperplasia seen on the soft palate and swelling of the eyelids. These symptoms usually present during the febrile phase of roseola. Cervical and postoccipital lymphadenopathy can also be seen, but this generally presents 2–4 days after the onset of the febrile phase.