Gloning H, Stettner-Gloning R, Pontz B F, Emmrich P
Kinderklinik und Poliklinik, Technischen Universität München.
Monatsschr Kinderheilkd. 1991 May;139(5):297-300.
We describe the unusual clinical course in a case of exanthema subitum with affection of the liver and central nervous system in a 10-months-old girl. HHV-6 infection was confirmed serologically (positive HHV-6 IgM from 10th to 29th day, increasing IgG-titres). At the beginning of the illness convulsions with preference to the right side were noticed, which were consistent with an encephalitis (on top to a suspected pre/perinatal lesion) and resulting in spastic triplegia. Nuclear magnetic resonance imaging and cranial computertomographic results showed severe, predominantly left-sided cerebral lesions. In addition there was clinical and biochemical evidence of an associated hepatitis. Human herpesvirus-6 has been identified as the cause of exanthema subitum. In addition, the virus is known to cause other clinical entities (lymphadenopathy, febril seizures, hepatitis, postinfectious chronic fatigue a.o.) and has been identified in brain tissues. Our observations show that the course of exanthema subitum can be complicated by affection of the liver and central nervous system. At present it is impossible to estimate the clinical outcome in our patient.
我们描述了一名10个月大女孩患幼儿急疹并伴有肝脏和中枢神经系统受累的不寻常临床病程。血清学证实为HHV - 6感染（第10天至29天HHV - 6 IgM阳性，IgG滴度升高）。疾病初期出现以右侧为主的惊厥，这与脑炎相符（叠加在疑似产前/围产期病变之上），并导致痉挛性三肢瘫。核磁共振成像和头颅计算机断层扫描结果显示严重的、主要为左侧的脑部病变。此外，有临床和生化证据表明存在相关肝炎。人类疱疹病毒6型已被确定为幼儿急疹的病因。此外，该病毒还可导致其他临床病症（淋巴结病、热性惊厥、肝炎、感染后慢性疲劳等），并已在脑组织中被发现。我们的观察结果表明，幼儿急疹的病程可能因肝脏和中枢神经系统受累而复杂化。目前尚无法估计我们这名患者的临床结局。
