Okada K, Ueda K, Kusuhara K, Miyazaki C, Tokugawa K, Hirose M, Yamanishi K
Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Pediatr Infect Dis J. 1993 Mar;12(3):204-8. doi: 10.1097/00006454-199303000-00006.
Exanthema subitum had been speculated to be a viral disease although its pathogen is unknown. Human herpesvirus 6 (HHV-6), first isolated in 1986, was proved by Yamanishi et al. to be the causal agent of exanthema subitum. To evaluate the role of HHV-6 as the causal agent in clinically diagnosed exanthema subitum, we tested for HHV-6 antibody in 57 infants with clinical exanthema subitum and exanthema subitum-like rash without fever. Of the 53 patients with clinical exanthema subitum 43 showed seroconversion or a significant rise in antibody titer to HHV-6, 7 were seropositive without significant rise and 3 remained seronegative. The clinical manifestations of these 43 infants with serologically confirmed HHV-6 infection were consistent with the classical characteristics of exanthema subitum. The 4 patients with atypical exanthema subitum showed significant rises in antibody titer. Our results therefore show that the majority of cases with typical clinical manifestations of exanthema subitum had HHV-6 infection. Most cases with HHV-6 infection had the typical clinical course of exanthema subitum, and a few cases might show an afebrile exanthema subitum-like rash.
幼儿急疹一直被推测为一种病毒性疾病，尽管其病原体尚不清楚。1986年首次分离出的人类疱疹病毒6型（HHV - 6），被Yamanishi等人证明是幼儿急疹的病原体。为了评估HHV - 6作为临床诊断的幼儿急疹病原体的作用，我们对57例临床诊断为幼儿急疹和无发热的幼儿急疹样皮疹的婴儿进行了HHV - 6抗体检测。在53例临床诊断为幼儿急疹的患者中，43例出现血清转化或HHV - 6抗体滴度显著升高，7例血清阳性但无显著升高，3例仍为血清阴性。这43例血清学确诊为HHV - 6感染的婴儿的临床表现与幼儿急疹的经典特征一致。4例非典型幼儿急疹患者的抗体滴度显著升高。因此，我们的结果表明，大多数具有幼儿急疹典型临床表现的病例都有HHV - 6感染。大多数HHV - 6感染病例具有幼儿急疹的典型临床病程，少数病例可能表现为无热的幼儿急疹样皮疹。
