Suga S, Yoshikawa T, Asano Y, Kozawa T, Nakashima T, Kobayashi I, Yazaki T, Yamamoto H, Kajita Y, Ozaki T
Department of Pediatrics, Toyokawa City Hospital, Japan.
Ann Neurol. 1993 Jun;33(6):597-603. doi: 10.1002/ana.410330607.
Twenty-one infants who had virologically confirmed exanthem subitum and central nervous system (CNS) complications were studied to elucidate the clinical features, laboratory and virological findings, and outcome. The primary infection with human herpesvirus 6 was confirmed by isolation of the virus from blood, a significant rise in the antibody titers to the virus, or both. All convulsive seizures (15 generalized and 6 focal) occurred during the pre-eruptive stage of exanthem subitum. Four infants with encephalitis/encephalopathy had more severe clinical features with abnormalities demonstrated on electroencephalograms and cerebral computed tomograms. All infants except those with encephalitis/encephalopathy recovered without any sequelae. One infant with encephalitis/encephalopathy developed epilepsy and another one died. Human herpesvirus 6 DNA amplified by the nested polymerase chain reaction method was detected in the cerebrospinal fluid of 6 infants, including 3 with encephalitis/encephalopathy, of 11 patients examined by the fifth day of the illness. These findings suggest that CNS complications including encephalitis/encephalopathy occur at the pre-eruptive stage of exanthem subitum, that human herpesvirus 6 invades the CNS in some patients, and that the outcome is not always benign.
对21例经病毒学确诊的幼儿急疹并伴有中枢神经系统（CNS）并发症的婴儿进行了研究，以阐明其临床特征、实验室及病毒学检查结果和预后情况。通过从血液中分离出病毒、病毒抗体滴度显著升高或两者兼而有之，确诊为人类疱疹病毒6型原发性感染。所有惊厥发作（15例全身性发作和6例局灶性发作）均发生在幼儿急疹出疹前期。4例患有脑炎/脑病的婴儿临床症状更严重，脑电图和脑部计算机断层扫描显示有异常。除患有脑炎/脑病的婴儿外，所有婴儿均康复且无任何后遗症。1例患有脑炎/脑病的婴儿发展为癫痫，另1例死亡。在发病第5天接受检查的11例患者中，6例婴儿的脑脊液中通过巢式聚合酶链反应法检测到人类疱疹病毒6型DNA，其中包括3例患有脑炎/脑病的婴儿。这些发现表明，包括脑炎/脑病在内的中枢神经系统并发症发生在幼儿急疹出疹前期，人类疱疹病毒6型在一些患者中侵入中枢神经系统，且预后并非总是良好。
