Human Herpesvirus 6 Clinical Presentation

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD   more...
 
Updated: Feb 27, 2012
 

Physical

Very few physical examination findings exist in children who are infected with human herpesvirus 6 (HHV-6) until skin findings become apparent. The eruption begins on the trunk and is composed of blanchable, erythematous papules. Children may also have febrile seizures and encephalitis.

Adults can have a wide variety of symptoms, which can be mild or severe. Healthy adults can have fever and CNS problems, such as encephalitis, but patients who are immunocompromised can have organ failure and death. Patients who have undergone transplantation can have accelerated rejection of the transplant.[13]

Neurologic manifestations

HHV-6 is a major precipitant of seizures in infants, not merely because of the high fever that the infection provokes but also because HHV-6 replicates in the CNS.

Reports of encephalitis as a complication of exanthem subitum and the appreciation that HHV-6 is highly neurotropic predicted that the virus might be associated with encephalitis in other settings as well. Current controversy exists regarding reports of HHV-6 in the brain of patients with multiple sclerosis. Active HHV-6 infection in the CNS has been postulated to promote inflammatory injury and demyelination, but this is far from proven.

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Causes

Human herpesvirus 6 (HHV-6) infection is responsible for roseola and is transmitted by saliva. Though rare, patients who are immunocompetent can have reactivation of HHV-6 and a recurrence of roseola.

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Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Cris Jagar  MD, Staff Physician, Department of Psychiatry, Trinitas Regional Medical Center

Disclosure: Nothing to disclose.

Ewa Koziorynska, MD  Assistant Professor of Neurology, Comprehensive Epilepsy Center, State University of New York Downstate Medical Center

Ewa Koziorynska, MD is a member of the following medical societies: Sigma Xi

Disclosure: none None None

Specialty Editor Board

Franklin Flowers, MD  Chief, Division of Dermatology, Professor, Department of Medicine and Otolaryngology, Affiliate Associate Professor of Pediatrics and Pathology, University of Florida College of Medicine

Franklin Flowers, MD, is a member of the following medical societies: American College of Mohs Micrographic Surgery and Cutaneous Oncology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

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