0%
Topic
Review Topic
0
0
N/A
N/A
Questions
0 1
0
0
100%
0%
Evidence
0 1
0
0
Snapshot
  • A 6-month old boy born at full term to a 26-year-old mother is brought to the emergency room for high fevers and seizure lasting less than 1 minute. The mother reports that he has been healthy without any medical problems and has met all 6-month milestones. Two days ago, he began having high fevers and some irritability, and today, he had a seizure. He was admitted for infectious workup. The next day, his fever resolved and he developed a morbilliform blanching rash on his trunk.
Introduction
  • Classification
    • human herpesvirus-6 (HHV-6)
      • an enveloped, linear, double-stranded DNA virus
      • transmission via respiratory secretions
      • causes roseola infantum (exanthem subitum)
  • Epidemiology
    • demographics
      • infants > children > adults
    • location
      • skin
    • risk factors
      • immunosuppression
      • transplant recipients
  • Pathogenesis
    • the virus replicates in salivary glands
    • the virus is latent in lymphocytes and monocytes
    • may contribute to tumor progression in Kaposi sarcoma and lymphoma
  • Associated conditions
    • may be associated with human herpesvirus-7
  • Prevention
    • no vaccines are available
  • Prognosis
    • does not commonly recur
    • disease is self-limited
Presentation
  • Symptoms
    • high fever for 3 days
    • may have febrile seizures
    • no upper respiratory symptoms
  • Physical exam 
    • light pink morbilliform rash that develops after the fever resolves
      • blanching 
      • discrete and irregular macules and papules
      • lasts 2 days
    • Nagayama spots
      •  erythematous papules on the mucosa of soft palate and uvula
Studies
  • Making the diagnosis
    • based on clinical presentation
Differential
  • Measles
    • distinguishing factor
      • cough, conjunctivitis, coryza, Koplik spots, and confluent rash excluding palms and soles
  • Rubella
    • distinguishing factor
      • post-auricular lymphadenopathy with non-confluent rash that desquamates
Treatment
  • Management approach
    • mainstay of treatment is supportive care
  • Conservative
    • supportive care
      • indication
        • all patients
      • modalities
        • antipyretics
        • hydration
Complications
  • Seizures
 

Please rate topic.

Average 5.0 of 2 Ratings

Questions (1)

(M1.MC.13.1) A 2-year-old male is brought to the emergency department by his mother following a seizure. The mother reports that he has had a fever for 3 days prior to convulsing while watching TV. You admit the patient to the hospital for further workup and observation. Three days later, you note the appearance of a papular, non-confluent rash on the patients back, extending superiorly towards the nape of the patient's neck. The abdomen and chest are shown in Figure A. What is the most likely diagnosis? Tested Concept

QID: 103790
FIGURES:
1

Roseola

46%

(65/140)

2

Variola

3%

(4/140)

3

Rubeola

21%

(29/140)

4

Rubella

25%

(35/140)

5

Mumps

4%

(6/140)

L 2 E

Select Answer to see Preferred Response

Evidences (1)
Topic COMMENTS (2)
Private Note