Sixth disease

Sixth disease or sixth childhood disease (exanthema subitum, roseola infantum) is a viral infectious disease caused by  human herpesvirus 6 (HHV 6), less often HHV 7. The sixth disease is one of the frequent rash diseases of childhood. The most affected are children under the age of three. The infection is most often transmitted by saliva from other family members.

However, the virus has also been detected in the urine, breast milk and genital secretions of women. Therefore, intrauterine transmission is also assumed.

After infection, the virus persists permanently in the body, just like other herpesviruses.

Clinical picture
The illness starts suddenly with a high fever (39-40 °C) that lasts for several days. Enlargement of the retroauricular and cervical nodes may occur during fever. After the fever subsides, a generalized macular or maculopapular exanthema appears on the trunk and proximal parts of the limbs. The rash subsides within a few hours to 2 days. It typically does not occur on the face.

The disease can also occur as a febrile illness without rash, with respiratory symptoms, diarrhea and increased irritability It can be accompanied by febrile convulsions.

Diagnosis
We establish the diagnosis on the basis of clinical symptoms, demonstration of specific antibodies (using the ELISA method) or direct isolation of the virus.


 * This disease is often confused with measles or rubella, which are far more serious and can be confirmed serologically.
 * If the doctor does not think of the sixth disease and prescribes antibiotics to treat the fever, the seeding of the rash can be confused with antibiotic allergy

Treatment
As it is a viral disease, the treatment is only symptomatic. We recommend patients a rest regime, plenty of fluids, or antipyretics.

Complications
As late complications, the following may rarely occur:
 * aseptic meningitis,
 * encephalitis,
 * hepatitis,
 * hematological malignancies,
 * infectious mononucleosis syndrome.