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Exanthem subitum (roseola infantum) with vesicular lesions

M Yoshida1, K Fukui, T Orita

  • 1Department of Dermatology, School of Medicine, Kinki University, Osaka, Japan.

Insights

A 7-month-old boy experienced skin lesions during exanthem subitum, confirmed as primary Human Herpesvirus-6 (HHV-6) infection. HHV-6 DNA was found in lesions and throat, with rising antibody levels supporting the diagnosis.

Area of Science:

  • Pediatrics
  • Virology
  • Dermatology

Background:

  • Exanthem subitum, commonly known as roseola infantum, is a frequent childhood viral illness.
  • Human Herpesvirus-6 (HHV-6) is the primary causative agent of exanthem subitum.
  • Cutaneous manifestations beyond the typical rash are less commonly reported in HHV-6 primary infections.

Observation:

  • A 7-month-old male infant presented with vesicular skin lesions.
  • These lesions appeared during the course of a febrile illness consistent with exanthem subitum.
  • The infant also exhibited symptoms localized to the throat.

Findings:

  • Polymerase chain reaction (PCR) detected Human Herpesvirus-6 (HHV-6) DNA in both the skin lesions and throat swab samples.
  • Serological testing revealed a significant increase in HHV-6 specific IgG antibodies and a stable IgM antibody titer.
  • The temporal pattern of antibody response (IgG rise, IgM stable) is characteristic of a primary viral infection.

Implications:

  • This case expands the clinical spectrum of primary HHV-6 infection to include vesicular lesions.
  • The findings highlight the utility of molecular and serological diagnostics in confirming HHV-6 etiology.
  • Understanding diverse clinical presentations is crucial for accurate diagnosis and management of HHV-6 infections in infants.

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