Materiały źródłowe

• #1 Roseola Infantum – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448190/

  Roseola infantum is a common disease of childhood that is seen globally and is caused by infection with human herpesvirus 6 (HHV-6), or, less frequently, by human herpesvirus 7 (HHV-7). […] Roseola infantum is most commonly caused by human herpesvirus 6 and less commonly, human herpesvirus 7. Human herpesvirus 6 has two variants: A and B. The primary variant that causes roseola infantum is HHV-6B. HHV-6A has not yet been linked to any disease. Both variants enter the cell via interaction with CD46. HHV-6B is involved in the fusion process to the cell membrane by an undefined mechanism, the nucleocapsid is transported through the cytoplasm, and the viral DNA genome is released into the nucleoplasm at nuclear pore complexes. It has been shown that HHV-6 replicates most effectively in CD4+ T cells and has a mean incubation period of nine to ten days.

• #2 Roseola Infantum: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1133023-overview

  Roseola infantum is a viral illness that occurs secondary to human herpesvirus (HHV)-6 or HHV-7 infection. It is characterized by high fevers for 3-4 days, followed by exanthema at defervescence. Febrile seizures can occur in as many as 15% of patients. […] Like other herpesviruses, HHV-6 then remains latent in most patients who are immunocompetent. Although clinical disease is uncommon (though not unknown) in patients who are immunocompetent, HHV-6 is a major cause of morbidity and mortality in patients who are immunosuppressed, particularly those with AIDS and those who are transplant recipients. […] In the primary infection, replication of the virus occurs in the leukocytes and the salivary glands. HHV-6 is present in saliva. A study monitoring HHV-6 and HHV-7 DNA in saliva samples during the acute and convalescent phases demonstrated a significantly higher rate of detection in children aged 3-9 years than in adults, suggesting that children in the convalescent phase of roseola infantum are the more probable source of infection. Early invasion of the central nervous system (CNS) is believed to occur, thus accounting for seizures and other CNS complications.

• #3 Roseola infantum (exanthem subitum) – UpToDate

  https://www.uptodate.com/contents/roseola-infantum-exanthem-subitum/print

  Roseola infantum (also known as exanthem subitum, sixth disease, pseudorubella, exanthem criticum, and three-day fever) is caused by the B variant of human herpesvirus 6 (HHV-6). […] The virology, pathogenesis, epidemiology, and other clinical manifestations of HHV-6 in children are discussed separately. […] Human herpesvirus 6B (HHV-6B) is the most frequent cause of roseola.

• #4 Roseola – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/756?locale=fr

  Roseola is a common febrile viral illness of early childhood; it is usually caused by human herpesvirus (HHV)-6B and occasionally by HHV-7. […] Roseola is most commonly caused by human herpesvirus (HHV)-6B, but occasionally by HHV-7 and rarely by other viruses. HHV-6A (associated with thyroiditis), HHV-6B (roseola), and HHV-7 (roseola) are lymphotropic viruses within the Herpesviridae family and Betaherpesvirinae subfamily, and all establish latency. HHV-6A, HHV-6B, and HHV-7 can occasionally integrate into the host chromosome. Reactivation of the roseola viruses may occur with immunosuppression.

• #5 Roseola Infantum | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/28644

  Human herpesvirus 6 replicates most commonly in the leukocytes and the salivary glands during the primary infection and will, therefore, be present in saliva. […] Research has shown that high levels of metalloproteinase 9 and tissue inhibitor of metalloproteinases 1 in the serum of infants infected with HHV-6 can lead to blood-brain barrier dysfunction which in return can aid in causing febrile seizures. […] Early invasion of the central nervous system (CNS) has also been shown. […] Roseola infantum is most commonly caused by human herpesvirus 6 and less commonly, human herpesvirus 7. […] Human herpesvirus 6 has two variants: A and B. The primary variant that causes roseola infantum is HHV-6B. […] Both variants enter the cell via interaction with CD46. […] HHV-6B is involved in the fusion process to the cell membrane by an undefined mechanism, the nucleocapsid is transported through the cytoplasm, and the viral DNA genome is released into the nucleoplasm at nuclear pore complexes. […] It has been shown that HHV-6 replicates most effectively in CD4+ T cells and has a mean incubation period of nine to ten days. […] HHV-6 remains latent in lymphocytes and monocytes after an acute primary infection with the salivary glands and brain tissue harboring persistent HHV-6 infection.

• #6 Roseola infantum (exanthem subitum) – UpToDate

  https://www.uptodate.com/contents/roseola-infantum-exanthem-subitum

  Roseola infantum (also known as exanthem subitum, sixth disease, pseudorubella, exanthem criticum, and three-day fever) is caused by the B variant of human herpesvirus 6 (HHV-6). […] The virology, pathogenesis, epidemiology, and other clinical manifestations of HHV-6 in children are discussed separately. […] Human herpesvirus 6B (HHV-6B) is the most frequent cause of roseola. […] Other causes include HHV-7, enteroviruses (coxsackieviruses A and B, echoviruses), adenoviruses, and parainfluenza virus type 1. […] Roseola is an illness of young children, with a peak prevalence between 7 and 13 months. […] Ninety percent of cases occur in children younger than two years. […] Roseola occurs equally in males and females. […] It occurs throughout the year, but the peak incidence is in the spring and fall seasons.

• #7 Roseola (Human Herpesviruses 6 and 7) – Clinical Tree

  https://clinicalpub.com/roseola-human-herpesviruses-and/

  Primary HHV-6B infection causes a viremia that can be demonstrated by co-culture of the patient’s peripheral blood mononuclear cells with mitogen-stimulated cord blood mononuclear cells. HHV-6 has a recognizable cytopathic effect, consisting of the appearance of large refractile mononucleated or multinucleated cells with intracytoplasmic and/or intranuclear inclusions. Infected cells exhibit a slightly prolonged life span in culture; however, lytic infection predominates. HHV-6 infection also induces apoptosis of T cells. In vitro, HHV-6 can infect a broad range of cell types, including primary T cells, monocytes, natural killer cells, dendritic cells, and astrocytes. HHV-6 has also been documented to infect B-cell, megakaryocytic, endothelial, and epithelial cell lines. Human astrocytes, oligodendrocytes, and microglia have been infected with HHV-6 ex vivo. The broad tropism of HHV-6 is consistent with the recognition that CD46, present on the surface of all nucleated cells, is a cellular receptor for HHV-6, HHV-6A in particular. CD134, a member of the TNFR superfamily, is the main entry receptor for HHV-6B and may explain some of the differences in tissue tropism noted between HHV-6A and HHV-6B. The CD4 molecule has been identified as a receptor for HHV-7. HHV-7 has been demonstrated to reactivate HHV-6 from latency in vitro, but whether this phenomenon occurs in vivo is not clear.

• #8 Roseola Infantum: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1133023-overview

  Evidence has suggested that high serum levels of matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinases (TIMP)-1 in infants infected with HHV-6 may lead to blood-brain barrier dysfunction, which may result in febrile seizures. […] After the acute primary infection, HHV-6 remains latent in lymphocytes and monocytes and has been found in low levels in many tissues. Peripheral blood mononuclear cell cultures develop enlarged balloonlike cells. Cells supporting virus growth are CD4+ T lymphocytes. HHV-6 downregulates the host immune response through several mechanisms, including molecular mimicry by production of functional chemokine and chemokine receptors. […] The two variants of HHV-6 are A and B. The genomes of HHV-6A/B have been sequenced. HHV-6B, the main cause of roseola, consists of 97 unique genes. CD46 is the cell receptor for HHV-6, which imparts the virus’s broad tissue tropism. Both HHV-6A and HHV-6B integrate their genome into the chromosomes of infected cells and also of germ cells; thus, infected individuals have a copy of the viral genome in all of their nucleated cells.

• #9 HHV-6, roseola (Herpesviridae) – Free Sketchy Medical Lesson

  https://www.sketchy.com/medical-lessons/hhv-6-roseola-herpesviridae

  Human herpesvirus 6 (HHV-6), a member of the Herpesviridae family, is a double-stranded DNA virus that primarily infects humans and is responsible for a disease called roseola. […] A key characteristic of HHV-6 is that it infects CD4 cells, namely helper T-cells, which can lead to immunosuppression by reducing the CD4 cell population. […] HHV-6 is a lymphotropic virus. It primarily infects CD4 cells, namely helper T-cells. Infection with HHV-6 can cause a decrease in CD4 cell numbers and potentially lead to an impaired immune response. Reactivation of latent HHV-6 can occur in immunocompromised individuals, leading to further health complications.

• #10 Roseola pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Roseola_pathophysiology

  Roseola has two phases, the febrile and the rash (maculopapular) phase. During the first phase, HHV6 replicates in salivary glands and is secreted as primary source of infection. After completes resolution of the febrile phase, due to the latency of the virus in the lymphocytes and monocytes, the rash phase begins. […] In the second phase of the disease, the HHV 6 virus is found to remain latent in lymphocytes and monocytes and found in low levels in some tissues. CD4 positive T cells have been found to support the growth of roseola. […] Infection of the CD134 cells has been shown in some studies to be responsible for the reactivation of HHV 6 from latency in vitro. The human herpes virus infects the T cells, monocytes-macrophages, epithelial cells, and central nervous system cells resulting in a lifelong latency or persistence of virus at multiple sites. HHV-6 exists in a true state of viral latency in monocytes and macrophages. […] HHV-6 has tropism towards CD4 T cells and replicates in the T cells inducing a lifelong latent infection in humans.

• #11 Roseola – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/roseola/symptoms-causes/syc-20377283

  Roseola is a childhood illness caused by two strains of the herpes virus. Common signs of roseola are a fever and a rash on the trunk and neck. […] Roseola is caused by a virus, usually human herpes virus 6 or sometimes human herpes virus 7. It is spread by contact with an infected person’s saliva, such as when sharing a cup, or through the air, such as when a person with roseola coughs or sneezes. It can take about 9 to 10 days for symptoms to develop after exposure to an infected person. […] Roseola is of greater concern in people with a weak immune system. You might have a weak immune system, for example, if you’ve recently had bone marrow transplant. People with a weak immune system have less resistance to viruses. They tend to develop more-severe roseola or complications such as pneumonia or encephalitis. Encephalitis is a potentially life-threatening inflammation of the brain.

• #12 What is the pathophysiology of roseola infantum? – MEDizzy

  https://medizzy.com/feed/29148492

  Pathophysiology of Roseola Infantum When HHV-6 enters the body, it binds with upper respiratory tract where it undergoes replication in the epithelial cells. Soon, virus invades the subepithelial tissue. After rapid replication, it spreads into body by hematogenous and lymphoid routes. This is followed by viremia. Virus infects the endothelial cells of blood vessels in the skin leading to the formation of maculopapular rashes on skin.

• #13 Roseola | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688864/all/Roseola?q=Bone+Cell+Marrow+Stem+Transplant+and

  Omnipresent infection occurring in infancy and childhood; majority of cases are caused by human herpesvirus 6 (HHV-6); may be associated with other diseases including encephalitis. […] HHV-6 binds to CD46 receptors on all nucleated cells (2). […] Lifelong latent or persistent asymptomatic infection occurs after primary infection (1). […] 80-90% of population intermittently sheds HHV-6/HHV-7 in saliva (2). […] Patients are viremic from 2 days prior to fever until defervescence and onset of rash. […] HHV-6 latency is also implicated in CSF.

• #14 Roseola Infantum – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448190/

  Human herpesvirus 6 replicates most commonly in the leukocytes and the salivary glands during the primary infection and will, therefore, be present in saliva. Research has shown that high levels of metalloproteinase 9 and tissue inhibitor of metalloproteinases 1 in the serum of infants infected with HHV-6 can lead to blood-brain barrier dysfunction which in return can aid in causing febrile seizures. Early invasion of the central nervous system (CNS) has also been shown. […] HHV-6 remains latent in lymphocytes and monocytes after an acute primary infection with the salivary glands and brain tissue harboring persistent HHV-6 infection.

• #15 Roseola (Human Herpesviruses 6 and 7) – Clinical Tree

  https://clinicalpub.com/roseola-human-herpesviruses-and/

  Primary infection with HHV-6 and HHV-7 is followed by lifelong latency or persistence of virus at multiple sites. HHV-6 exists in a true state of viral latency in monocytes and macrophages. The detection of replicating HHV-6 in cultures of primary CD34+ hematopoietic stem cells has also been described, suggesting that cellular differentiation is a trigger of viral reactivation. This observation is clinically significant because HHV-6 may cause either primary or reactivated infection during HSCT. Additionally, HHV-6 and HHV-7 infection may be persistent in salivary glands, and DNA of both HHV-6 and HHV-7 can be routinely detected in the saliva of both adults and children. HHV-7 can also be isolated in tissue culture from saliva, but HHV-6 cannot. HHV-6 DNA has been identified in the cerebrospinal fluid (CSF) of children, both during and subsequent to primary infection, as well as in brain tissue from immunocompetent adults at autopsy, implicating the central nervous system as an additional important site of either viral latency or persistence. HHV-7 DNA has also been found in adult brain tissue but at a significantly lower frequency.

• #16 Roseola – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/756

  Roseola is usually caused by human herpesvirus (HHV)-6B and occasionally by HHV-7. […] HHV-6A, HHV-6B, and HHV-7 can occasionally integrate into the host chromosome. Reactivation of the roseola viruses may occur with immunosuppression.

• #17 Roseola (viral rash): Causes, Symptoms, and Treatment — DermNet

  https://dermnetnz.org/topics/roseola

  Roseola is a disease caused by the human herpes virus type 6B (HHV-6B) and possibly type 7 (HHV-7). […] Reactivation of HHV-6 in immune suppressed patients or in association with drug hypersensitivity syndrome results in fever, rash, pneumonia, hepatitis, bone marrow suppression and encephalitis.

• #18 Roseola (Sixth Disease)

  https://www.healthline.com/health/roseola

  Roseola is a viral illness that is usually caused by exposure to the human herpesvirus (HHV) type 6 or 7. […] Roseola is most often caused by human herpesvirus 6, which has an incubation period of around 9-10 days. […] The incubation period how long it takes to get sick after exposure for roseola is usually 9 or 10 days. […] Roseola leads to febrile seizures in about 15 percent of children with the infection due to high fever. […] In very rare cases, roseola can lead to other serious health complications, including: encephalitis (brain tissue inflammation), pneumonia (lung infection), meningitis (inflammation of membranes around the brain and spinal cord), hepatitis (liver inflammation, often caused by virus), myocarditis (inflammation of the heart muscle), rhabdomyolysis (breakdown of muscle tissue that releases a dangerous protein into the bloodstream), thrombocytopenia (low blood platelet count), Guillain-Barr syndrome (an autoimmune disorder that attacks the nervous system).

• #19

  https://link.springer.com/article/10.1007/s12098-022-04344-4

  Roseola infantum is a common disease of childhood caused by infection with human herpesvirus 6 (HHV-6), self-limited with an excellent prognosis, although its acute presentation may concern both parents and health care providers. […] HHV-6 infection is an established cause of irritability, bulging fontanel, and febrile seizures in infants, resembling a severe neurological disease. […] HHV-6 encephalitis is rarely reported in immunocompetent children during primary infection and almost exclusively in Japanese patients, due to a genetic predisposition involving a characteristic pattern of cytokines response. […] The absence of CSF pleocytosis implies that the main pathological mechanism of cerebral involvement is not the viral replication in CSF, but rather the inflammation due to cytokines indirectly induced in the brain by a systemic immune response to HHV-6 infection.

• #20

  https://link.springer.com/article/10.1007/s12098-022-04344-4

  It has been suggested that inflammatory cytokines increase CSF production, resulting in intracranial hypertension, and thus, a bulging fontanel. […] In conclusion, although HHV-6 infection may present with concerning neurological signs, it (almost) never causes severe neurological disease in immunocompetent children.

• #21 Identifying the mechanism of virus-induced lupus – Lupus Research Alliance

  https://www.lupusresearch.org/for-researchers/funded-research/grant/identifying-the-mechanism-of-virus-induced-lupus/

  While the causes are unclear, genetic factors and environmental exposures (like viral infections) contribute to the development of systemic lupus erythematosus (SLE). […] Roseolovirus has been associated with the development of SLE; but understanding how viral infection can cause SLE is difficult due to the time between the initial infection and the development of SLE symptoms as well as the lack of animal models for studying this process. […] Overactive immune cells called T and B cells play a major role in lupus by mistakenly targeting a persons own cell contents as foreign invaders, leading to inflammation and organ damage. […] The toll-like receptor (TLR7) pathway is overactive in people with SLE and is triggered by viral infection. […] Dr. Bigley will test whether roseolovirus infection changes TLR7 activity in T and B cells and cause these cells to cause autoimmune disease.

• #22 Identifying the mechanism of virus-induced lupus – Lupus Research Alliance

  https://www.lupusresearch.org/for-researchers/funded-research/grant/identifying-the-mechanism-of-virus-induced-lupus/

  He predicts that these changes underlie the development of SLE in children. […] He will use this model to understand how viral infection causes long-term changes in T and B cells. […] The cause of systemic lupus erythematosus (SLE) remains unknown, but genetic and environmental factors are thought to play an important role. […] Viral infections have been proposed to contribute to onset and flares in SLE but few studies have looked at how viral infection early in life could predispose some people to developing SLE later in life. […] This suggests that early infection with MRV predisposes mice to autoimmunity and abnormal response to TLR7 stimulation, resulting in lupus like disease. […] We plan to study how MRV infection early in life leads to long term changes in T and B cells, both of which play an important role in SLE. […] Taken together, we have found an exciting new way to study how roseoloviruses, a common infection in humans, skews the development of the immune system toward autoimmune disease and SLE.

• #23 Roseola Infantum: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1133023-overview

  A possible association of HHV-6 with multiple sclerosis (MS) has been suggested, but study results have been conflicting. However, a large collaborative study that included 8742 patients with MS and 7215 health control subjects found that seropositivity for HHV6A was associated with an increased risk of future MS. […] HHV-6 has been isolated in Kaposi sarcoma (caused by HHV-8), where it may contribute to tumor progression. HHV-6 may facilitate oncogenic potential in lymphoma and has been associated with chronic fatigue syndrome.

• #24

  https://step2.medbullets.com/pediatrics/120584/roseola-infantum

  the virus replicates in salivary glands […] the virus is latent in lymphocytes and monocytes […] may contribute to tumor progression in Kaposi sarcoma and lymphoma

• #25 Roseola (Sixth Disease) Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/15785-roseola-infantumsixth-disease

  Roseola is a viral infection that mostly affects babies and young children, typically in the first two years of life. Roseola is caused by the human herpesvirus 6, with human herpesvirus 7 causing a few cases. […] Roseola is contagious and spreads through saliva or respiratory droplets, often from people who don’t yet have any symptoms. […] It takes anywhere from five to 15 days for symptoms to start after exposure to a virus that causes roseola. […] Most children have no complications. However, among those that do, the most common issue is a febrile seizure. […] Children rarely have more serious complications from roseola. However, they can occur, especially for children who have weakened immune systems due to cancer, autoimmune disease or other conditions. Possible complications include infection and inflammation in their lungs (pneumonia), inflammation of the delicate layer of tissue surrounding their brain and spinal cord (aseptic meningitis), and inflammation of their brain (encephalitis).

• #26 Roseola – Wikipedia

  https://en.wikipedia.org/wiki/Roseola

  There are nine known human herpesviruses. Of these, roseola has been linked to two: human herpesvirus 6(HHV-6) and human herpesvirus 7(HHV-7), which are sometimes referred to collectively as Roseolovirus. These viruses are of the Herpesviridae family and the Betaherpesvirinae subfamily, under which Cytomegalovirus is also classified. HHV-6 has been further classified into HHV-6A and HHV-6B, two distinct viruses that share 88% of the same DNA makeup, with HHV-6B the most common cause of roseola. After infection, these viruses enter a latent phase. Roseola caused by HHV-7 has been linked to the ability of HHV-7 infection to reactivate latent HHV-6. […] After exposure to roseola, the causative virus becomes latent in its host but is still present in saliva, skin, and lungs. HHV-6 is thought to be transmitted from previously exposed or infected adults to young children by shedding the virus through saliva. Even so, most cases of roseola are transmitted without known exposure.

• #27 Roseola | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688864/all/Roseola

  Omnipresent infection occurring in infancy and childhood; majority of cases are caused by human herpesvirus 6 (HHV-6); may be associated with other diseases including encephalitis. […] HHV-6 binds to CD46 receptors on all nucleated cells (2). […] Lifelong latent or persistent asymptomatic infection occurs after primary infection (1). […] 80-90% of population intermittently sheds HHV-6/HHV-7 in saliva (2). […] HHV-6 latency is also implicated in CSF.

• #28 Roseola (exanthem subitum, sixth disease) – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/roseola/roseola+exanthem+subitum+sixth+disease+-+including+symptoms+treatment+and+prevention

  Roseola is caused by infection with a virus called human herpes virus-6 (HHV-6). Almost all children have been infected with HHV-6 by the age of 2 years. […] Roseola is likely spread by direct contact with the saliva of an infected person, frequently from mother to infant. It is also spread from mother to child during birth. […] Diagnosis is made by clinical presentation. […] Saliva, nasal and throat secretions are most infectious from a few days before until several days after the rash appears. […] No specific antiviral therapy is required. Fever may be treated with paracetamol. Aspirin should not be given to children under 12 years of age unless specifically recommended by a doctor. […] there is no vaccine available to prevent this infection.

• #29 Roseola – Causes, Symptoms, Treatment, Diagnosis – MedBroadcast.com

  https://medbroadcast.com/condition/getcondition/roseola

  Roseola is a viral infection that begins with a sudden high fever and is followed by the appearance of a rose-coloured rash. […] Roseola is a common childhood infection that is caused by the same family of viruses that is responsible for chickenpox and shingles. […] For the first week or two after becoming infected, the virus will multiply in the body, usually causing no symptoms. […] There is currently no vaccine available to prevent infection with the virus that causes roseola.

• #30 Roseola – Skin Deep

  https://dftbskindeep.com/all-diagnoses/roseola/

  Roseola is a mild, self-limiting viral illness caused by the human herpes virus type 6B or 7. It generally presents between 6 months and 3 years of age, with an estimated 80-90% of children having been affected during their first 2 years of life. […] It is droplet spread and is most infectious during the first few days (fever phase). […] Initial symptoms include a high fever, runny nose and the child being generally out of sorts and tired. […] After 3-5 days of these initial symptoms resolve and a fine macular papular red/pink rash appears over the trunk. […] The rash is painless, not itchy, and does not blister. […] No treatment is required and complications are rare, but can include febrile convulsions.

• #31 Roseola Infantum: An Updated Review – Leung – Current Pediatric Reviews

  https://journals.eco-vector.com/1573-3963/article/view/645462

  Roseola infantum is a viral illness characterized by high fever that lasts 3 to 4 days, followed by the sudden appearance of rash at defervescence. […] Human herpesvirus-6 (HHV-6) is the major cause of roseola infantum, followed by HHV-7. […] Transmission of the infection most likely results from the asymptomatic shedding of the virus in the saliva of the caregivers or other close contacts. […] The diagnosis is mainly clinical. […] In general, serious complications are rare and occur more often in individuals who are immunocompromised. […] There is no specific treatment. […] Roseola infantum is generally a benign and self-limited disease. […] Failure to recognize this condition may result in undue parental fear, unnecessary investigations, delay in treatment for conditions that mimic roseola infantum and complications from roseola infantum, unnecessary treatment of roseola infantum per se, and misuse of healthcare expenditure.

• #32 Roseola Infantum – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/common-viral-infections-in-infants-and-children/roseola-infantum

  Roseola infantum is an infection of infants or very young children caused by human herpesvirus 6B (HHV-6B) or, less commonly, HHV-7. […] Roseola infantum is the most well-described illness to result from human herpesvirus-6 (HHV-6); 2 distinct HHV-6 species, A and B, exist with most if not all clinical disease linked to HHV-6B infection. HHV-6B may also cause central nervous system (CNS) disease in patients who are immunocompromised (eg, hematopoietic stem cell transplant recipients). […] In roseola infantum, the characteristic rash occurs with defervescence. […] Foscarnet or ganciclovir has been used to treat some patients who are immunosuppressed who have severe disease, particularly encephalitis, but controlled trials are lacking.

• #33 Roseola Infantum – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/common-viral-infections-in-infants-and-children/roseola-infantum

  Roseola infantum is caused by infection with human herpesvirus-6. […] The usual cause of roseola infantum is herpesvirus-6, one of the many human herpesviruses. […] A person who has had roseola infantum develops immunity and usually cannot contract it again. […] Tests are rarely done, but the diagnosis of roseola infantum can be confirmed with blood tests. […] If the disease is severe in children with a weakened immune system, doctors may treat them with the antiviral medication foscarnet or ganciclovir.

• #34 Roseola (Sixth Disease)

  https://www.healthline.com/health/roseola

  There is no specific test that can be used to diagnose roseola, although sometimes a blood test can identify its antibodies. […] Most cases of roseola occur in childhood and are not serious. […] In certain children or adults with a weakened immune system, physicians might prescribe an antiviral drug, such as ganciclovir (Cytovene). However, these drugs are not officially approved to treat HHV-6, one of the viruses that cause roseola. […] Most children develop antibodies to roseola by the time they are toddlers, which makes them immune to a repeat infection.

• #35 Roseola Infantum (Sixth Disease): Symptoms & Treatment | Ada

  https://ada.com/conditions/roseola-infantum/

  Roseola is caused by two viruses in the herpes family: HHV, or human herpes virus, most often type 6 or occasionally type 7. The virus is spread via droplet infection, when an infected person coughs or sneezes, or through direct contact with an infected person or item that was, for example, sneezed on by an infected person. […] Roseola is most commonly caused by human herpes virus 6 (HHV-6), though it can also be caused by human herpes virus 7 (HHV-7). These types of herpes are different to the strains that cause cold sores and genital herpes. […] The virus is spread through droplets of fluid from the mouth, throat and nose, for example when a person coughs or sneezes. Contact with a person who has roseola, or items that have been contaminated with infected droplets can result in the virus being transmitted. […] The roseola virus remains in the body for life, making reactivation or reinfection possible at a later stage. This is more likely to occur if the person becomes immunocompromised, for example, while undergoing treatment for cancer or receiving a bone marrow transplant.

• #36 Roseola: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/320357

  Roseola can spread between children even when no rash is present, and it can occur at any time of the year. […] The condition is caused by a virus, more commonly human herpes virus 6, but also human herpes virus 7. […] Most children will contract roseola at a young age. They are at greatest risk between the ages of 6 and 15 months of age when their immune systems have not yet developed antibodies to fight the virus, as this illness occurs upon virus exposure. […] People with weak immune systems may experience complications if they contract roseola. Examples of groups with compromised immunity include people with HIV and AIDs or leukemia and recent recipients of organ transplants. […] If people with weakened immunity acquire roseola, or experience a reactivation of a previous infection, they may develop a more severe case of the illness and struggle to recover from the virus. […] A doctor may prescribe the antiviral medication ganciclovir (Cytovene) for some people with weak immune systems to try to prevent the virus from replicating its DNA.

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