Causes
Exanthema (also called sudden exanthema) is caused by human herpes viruses types 6 and 7 (HHV-6 and HHV-7) - the first is more dangerous and is the main causative agent. Once in the body, viral particles interact with immune complexes, provoking the formation of exanthema. Also, such viruses interact individually with the following biological structures:
- T lymphocytes;
- monocytes;
- macrophages (cells that devour foreign elements that enter the body);
- astrocytes;
- tree-like cells;
- epithelial cells, etc.
Exanthema in adults is observed much less frequently. It should be remembered that in adolescent children and adults, the HHV-6 virus is associated with a urinary infection, which is characterized by an asymptomatic course. Also, such a virus can, without manifesting itself, live in the tissues of the central nervous system, then become activated and cause:
- myelitis – inflammation of the soft tissues of the brain and spinal cord;
- meningoencephalitis is an inflammation of both soft tissues and meninges.
In addition, there is evidence that HHV-6 is capable of causing the development of lymphoproliferative pathologies - those that are manifested by the proliferation of lymphoid tissue. This means that when exanthema is detected, one should be wary of the described pathologies provoked by this type of virus.
How long is the incubation period for roseola?
The causative agent of the disease is the sixth type of herpes virus, which, when it gets on the skin and tissues, causes their damage. By reacting with immune cells, the pathogen provokes the appearance of a characteristic rash. In adults, the virus causes chronic fatigue syndrome, and in children under three years of age - sudden exanthema. How long is the incubation period for roseola? – 3-7 days. Although there are cases when the incubation period reaches 15 days.
Most often, pseudorubella is diagnosed in the spring and autumn.
Signs of exanthema
The incubation period (the time the pathogen remains in the body without any clinical manifestations) lasts from 5 to 15 days.
Symptoms of exanthema:
- fever - chills and hyperthermia (increase in body temperature - up to 39.0-40.5 degrees Celsius). The period lasts up to three days;
- weakness and lethargy;
- apathy (indifference to everything happening around);
- deterioration of appetite, and then its complete disappearance;
- nausea.
Less commonly, children exhibit signs of exanthema such as diarrhea, nasal congestion, swelling of the eyelids and tissues around the eyes, and a rash on the soft palate. In this case, there is no runny nose or cough. With exanthema in children, convulsions may develop against the background of the described clinical picture.
On the fourth day, the temperature drops, which creates a false impression of recovery. But almost immediately a non-contagious rash appears on the child’s body in the form of small dots or spots. It disappears after 2-4 days.
What does a roseola rash look like in a child?
The rash of baby fever is very similar to the rash of rubella. Small, pale pink pimples do not itch or cause any discomfort. Localization of rashes is the child’s back, stomach and chest. The rash is not contagious to others and usually goes away within five days. Your doctor will tell you more about what a roseola rash looks like in a child during your consultation.
Please note that with pseudorubella the baby does not have a cough, runny nose or other symptoms characteristic of ARVI.
Additional symptoms:
- swelling and redness of the eyelids;
- enlargement of individual lymph nodes;
- slight swelling of the mucous membranes;
- increased drowsiness.
Increased body temperature with roseola disease lasts no more than three days, after which a period of profuse rashes begins. The rash is irregular in shape and light pink in color. When pressed, pimples become whitish. The islands of rashes do not merge with each other.
On our website Dobrobut.com you can make an appointment with a doctor who will tell you the difference between syphilitic roseola spots in adults and skin manifestations of pseudorubella. At the center you can undergo a full examination of the body and receive a transcript of the research results.
Diagnostics
Is it easy to diagnose exanthema in children? The signs are typical, but the diagnosis is made in a timely manner quite rarely. While the examination is being carried out, the symptoms of the infection may disappear on their own, without medical intervention. However, even if the child’s condition improves, he must be carefully examined.
A thorough examination of the elements of the rash is necessary. These are small pink spots and papules with a diameter of up to 1-5 mm. Elements of the rash rise slightly above the surface of the skin.
Instrumental methods are used in case of complications of exanthema:
- electroencephalography;
- electrocardiography;
- ultrasound examination of the abdominal organs and some others.
Laboratory diagnosis of exanthema includes the following methods:
- general blood test - a decrease in the number of leukocytes and eosinophils is noted;
- cultural method (seeding) – it is used to identify the active virus in the child’s body;
- enzyme immunoassay of blood - immunoglobulins IgG and IgM to HHV-6 and HHV-7 are detected in the blood.
Virus with a "trick"
Unfortunately, the correct diagnosis is not always made. A child’s medical record often contains a note about an illness that he did not tolerate - for example, rubella or an allergic rash.
Possible “scenarios” for roseola
Teething
Parents often attribute unreasonable high fever to teething. Whereas in a healthy child this process is accompanied only by anxiety and crying due to painful sensations.
What are the consequences of mistakes?
It is expected that as soon as the tooth appears, the baby’s well-being will improve. In fact, an increase in body temperature, the appearance of diarrhea, vomiting, cough or runny nose are always signs of some kind of disease, one of which is roseola.
Intensive "treatment"
During an unexplained fever, a child often manages to take several medications. Antibiotics and antivirals are often used unjustifiably. Independent normalization of body temperature and improvement of well-being after a few days is perceived as a positive dynamics of treatment.
And here a rash appears on the skin - it is considered as a manifestation of a drug allergy. Antiallergic drugs are used, giving the expected “effect” by the time the rash disappears on its own.
Note to mom : allergic rashes are itchy and vary in size, and can be in the form of spots, nodules or blisters.
What are the consequences of mistakes?
Use of antibiotics:
* Not only pathogenic microorganisms are destroyed, but also beneficial intestinal microflora, which is then difficult and long to recover.
* The body's defenses weaken - the penetration of bacteria and viruses into the body becomes easier.
Antiallergic drugs are an extra drug burden on an immature child’s body. Antiviral drugs boost the immune system. If they are used uncontrolled, it is unknown in which direction the shift will occur.
Misdiagnosis of rubella or measles
Rashes with roseola, measles and rubella have some similarities, but there are many differences between the ailments.
Treatment of exanthema in children
The contagiousness of the virus is not very high, but sick children should be isolated. There is no specific treatment. Treatment of exanthema with the correct prescriptions does not delay.
Destination:
- at high temperatures - drink plenty of fluids;
- limiting walks until body temperature normalizes;
- antipyretics;
- antiviral drugs;
- antihistamines.
During the period of treatment of exanthema in children, regular wet cleaning of the room is necessary.
Complications, prognosis and prevention of the disease
In most cases, the prognosis is favorable. If you follow all the doctor’s recommendations, roseola goes away within 7 days without complications. In severe cases, the disease can be complicated by febrile convulsions, bronchitis, otitis media and pneumonia (against the background of reduced immunity).
Prevention. It is extremely difficult to prevent herpes infection. A good preventive measure would be strengthening the baby's immunity (good rest, walks in the fresh air, proper nutrition, active games) and cleanliness in the children's room (wet cleaning every three days).
If you have any doubts, sign up for a consultation by phone or fill out the form on the website. How the roseola virus is transmitted, what should be done first if you suspect the disease - the doctor will answer all questions during the consultation.
Cytomegalovirus infection
An infectious disease that is caused by cytomegalovirus (CMV) and is characterized by a variety of clinical forms (from asymptomatic to severe generalized with damage to many organs) and course (acute or chronic). CMV transmission factors can be almost all biological substrates and human secretions that contain the virus: blood, saliva, urine, cerebrospinal fluid, vaginal secretions, sperm, amniotic fluid, breast milk. Potential sources of infection are organs and tissues in transplantology, as well as blood and its products in transfusiology. Routes of transmission of CMV infection: airborne, sexual, vertical and parenteral.
There are congenital and acquired forms of CMV infection. Congenital CMV infection. During antenatal infection of the fetus, infection occurs predominantly transplacentally. During intrapartum infection, CMV enters the body through aspiration of infected amniotic fluid or secretions from the mother's birth canal.
In older children, acquired CMV infection occurs in a subclinical form in 99% of cases. The most common manifestation of this form of CMV infection in children over one year of age is mononucleosis-like syndrome. As a rule, a clinical picture of acute respiratory disease is observed in the form of pharyngitis, laryngitis, and bronchitis.
Infections caused by the sixth, seventh and eighth types of herpes viruses Type six herpes viruses (HHV-6) can cause erythematous and roseolous rashes (sudden exanthema), lesions of the central nervous system and bone marrow in immunocompromised children. Herpesvirus type seven (HHV-7) causes neonatal exanthema
For the diagnosis of herpes infection, cytological, immunofluorescent, serological and PCR methods are valuable. Virological testing for herpes infection reveals complement-fixing antibodies to HSV-1 or -2 in the mother's blood, fetal cord blood and amniotic fluid. PCR method. The material for testing for herpes is blood, throat swabs, the contents of blisters, ulcers, and urine.
The study of specific antibodies of various subclasses: IgM, IgG1-2, IgG3 and IgG4 to herpes viruses is important. The detection in the blood serum of children of specific immunoglobulins M, IgG3, IgG1-2 in a titer > 1:20, viral antigen and specific immune complexes with antigen indicates the severity of the infectious process (active phase), and the determination of only specific IgG4 is regarded as the latent phase of infection or carriage of maternal antibodies.
Herpes simplex virus types 1 and 2
The term “herpes infection” (HI) is usually used to refer to diseases that are caused by HSV-1 and HSV-2. The source of HSV infection are sick people with various forms of the disease, including latent ones, as well as virus carriers.
HSV-1 is transmitted by airborne droplets and contact. When the virus gets on the skin during a cough or sneeze, it is contained in droplets of saliva and survives for an hour. On wet surfaces (washbasin, bathtub, etc.) it remains viable for 3-4 hours, which is often the cause of disease outbreaks in preschool institutions. Infection can occur through kissing, as well as through household items that are infected with the saliva of a patient or virus carrier. HSV-2 is transmitted sexually or vertically. With the latter, infection occurs during childbirth (contact with the mother's birth canal), transplacentally or through the cervical canal in the uterine cavity. Due to the fact that viremia occurs during generalization of infection, transfusion or parenteral transmission of HSV-2 infection is also possible. HSV-2 usually causes genital and neonatal herpes.
Children are most susceptible to GI between 5 months and 3 years of age. Depending on the mechanism of infection, acquired and congenital forms of HI are distinguished. Acquired HI can be primary and secondary (recurrent), localized and generalized. A latent form of GI is also isolated.
No infection has such a variety of clinical manifestations as the herpes virus. It can cause damage to the eyes, nervous system, internal organs, mucous membrane of the gastrointestinal tract, oral cavity, genitals, can cause cancer, and has a certain significance in neonatal pathology and the occurrence of hypertension. The spread of the virus in the body occurs through hematogenous, lymphogenous, and neurogenic routes.
The frequency of primary herpesvirus infection increases in children after 6 months of life, when antibodies received from the mother disappear. The peak incidence occurs at the age of 2-3 years. HI often occurs in newborns; according to a number of authors, it is diagnosed in 8% of newborns with general somatic pathology and in 11% of premature infants.
According to WHO, diseases caused by the herpes simplex virus (HSV) are the second leading cause of death from viral infections after influenza. Solving the problem of diagnosing and treating herpesvirus infection with manifestations on the oral mucosa is one of the most important tasks of practical medicine.
In the last decade, the importance of herpesvirus diseases as a public health problem has been constantly growing throughout the world. Members of the human herpesvirus family infect up to 95% of the world's population.
Primary forms of GI include: infection of newborns (generalized herpes, encephalitis, herpes of the skin and mucous membranes), encephalitis, gingivostomatitis, Kaposi's eczema herpetiformis, primary herpes of the skin, eye, herpetic panaritium, keratitis. Primary HI occurs due to initial human contact with HSV. As a rule, this occurs in early childhood (up to 5 years). In adults aged 16-25 years who do not have antiviral immunity, primary HI may more often be caused by HSV-2. 80-90% of initially infected children carry the disease latently, and only in 10-20% of cases are clinical manifestations of the disease observed.
Secondary, recurrent forms of GI are herpes of the skin and mucous membranes, ophthalmic herpes, and genital herpes.
