Viral exanthema in children: signs and therapy. Sixth disease or sudden exanthema!!! Exanthema in adults

There are different types of exanthema, differing in symptoms and cause. In pediatrics, a sudden rash is most common. It is most common in children aged 6 months to 2 years.

Causes of exanthema

The cause of exanthema in most cases is a virus. The infection mechanism is triggered by the following factors:

• The pathogen spreads through the body with blood flow, enters the dermis and causes inflammation. This is how enteroviral exanthema develops;
• A rash occurs as an immune response to an irritant. The process is typical for rubella and measles.

In some cases, exanthema appears without an infectious provocateur, only under the influence of immune factors (, allergic dermatitis,.).

Of the many viral pathogens, a rash is most often caused by an enterovirus infection. This is followed by agents of measles, human herpes, and parvovirus B19. In adults, the cause of the disease can be autoimmune disorders or drug allergies.

Symptoms of exanthema

Symptoms of exanthema are very diverse. They are divided into general, characteristic of all rashes, and local, defining any one type of disease.

Common manifestations of exanthema include:

• swollen lymph nodes;
• shortness of breath
• aching muscles;
• headache;
• catarrhal phenomena;
• elevated body temperature;
• loss of appetite;
• indigestion.

The main symptom of exanthema is a rash. It can manifest itself in different ways, but always occurs against the background of fever and directly depends on the underlying cause.

For example, with measles, pathological elements appear on the 5th day, first capturing the face and then spreading throughout the body. The spots combine with each other, turning into large foci. Rubella also appears, only the rashes do not merge with it.

Enterovirus infection occurs with indigestion, symptoms of a respiratory disease, temperature. A variety of elements of the rash appear on the skin: vesicles, nodules, spots. Sometimes there is itching.

If the exanthema is caused by herpes, skin changes occur on the back and abdomen, and then spread to other parts of the body.

Exanthema in children

Exanthema in children proceeds as an acute infectious disease. It usually affects children under the age of 3 years. Symptoms of pathology depend on its type. Enteroviruses are the most common cause of childhood exanthema.

The first signs of a rash are recorded after a high temperature. A similar reaction of the body is an immune response to a viral pathogen. Children of older preschool and school age suffer from exanthema much less often, because their immune system is more stable and does not react so brightly to stimuli.

Types of exanthema

Doctors distinguish several forms of exanthema, each of which has its own causes and symptoms.

Sudden exanthema

As the name implies, this type of pathology occurs unexpectedly and ends very quickly. Doctors call it baby roseola or sudden fever. The cause of the disease is herpes.

The disease affects children under the age of one year and is accompanied by fever and maculopapular exanthema, similar to rubella.

The frequency of herpes lesions is higher in winter and autumn. Once in the body, the virus remains in it for life, being most of the time in a passive state. Having recovered, the baby develops immunity to infection, but under adverse conditions it can get sick again, having become infected from an adult.

Manifestations of unexpected exanthema in a child:

• runny nose;
• quickened stool;
• tearing and redness of the eyes;
• irritability, tearfulness.

The rash appears on the 2-3rd day, affecting the upper body and face. After a few days, the exanthema disappears without a trace. A longer course of roseola indicates the addition of an allergy.

Viral exanthema

Viral exanthema in children occurs up to a year and is always accompanied by fever. Bubbles, spots or nodules appear on the skin, which can merge into a focus or be located separately. Symptoms of the disease depend on the virus that caused the skin lesion.

Parvovirus B19 presents with reddening of the cheeks like lace or square weaving. Enterovirus infection is accompanied by a generalized rash consisting of many small nodules. Rotavirus is characterized by red spots rising above the skin, which soon merge into a single focus. Adenovirus is characterized by the development of itching and conjunctivitis.

A common symptom of viral exanthema is swollen lymph nodes. The disease proceeds without complications and ends on 4–5 days.

Vesicular exanthema

Vesicular exanthema is diagnosed with pathologies caused by herpes, chickenpox or smallpox rickettsiosis. Vesicles are also observed in the non-infectious nature of the ailment: eczema, prickly heat, dyshidrosis.

Herpes infection is the most common cause of exanthema. Numerous, fluid-filled vesicles occur simultaneously with fever. They can be located on the mucous membrane of the mouth (enanthema), wings of the nose, in the area of ​​​​the forearms, on the arms and legs. In adolescents, they are often localized in the genital area.

With an uncomplicated form of malaise, the vesicles open on the 5-6th day and begin to heal.

Infectious exanthema

Infectious exanthema (Boston, enteroviral exanthema) is provoked by agents from a number of ECHO viruses, accompanied by high fever, symptoms of general intoxication and papular rashes. The disease occurs most easily in children under the age of three. Adolescents and adults are much more severely ill.

Enterovirus infection begins with high fever, weakness, headache and muscle pain. The rash appears after 2 days and quickly captures the entire body with the development of enanthems. Resembles morbilliform lesions.

Infectious exanthema lasts up to one week, and then disappears without a trace.

Is exanthema contagious?

As for the rash itself, it is not contagious. However, a sick child is a carrier of a rather contagious virus and can infect others.

For example, Boston exanthema is easily transmitted by airborne or alimentary routes. Cases of intrauterine infection of the fetus have been reported. A sick baby is recommended to be isolated from the team and put to bed. This will reduce the chance of transmitting the pathogen.

Which doctor treats exanthema?

If a skin rash appears, accompanied by fever and headache, you should contact or.
If there are no such specialists at the local clinic, it is recommended to visit or make an appointment with. A small child should be shown or childish.
If the baby has a severe fever, diarrhea, severe anxiety, crying, you need to call an ambulance or invite a doctor from the children's clinic to the house.

Diagnostics

When diagnosing exanthema, differentiation comes first. A viral rash must be distinguished from other skin lesions. To do this, a thorough physical examination of the patient is carried out in daylight or a bright lamp. During the examination, the dermatologist pays attention to the nature and size of the elements, their location and tendency to merge.

To confirm the exanthema, the following diagnostic measures are carried out:

• RNA test;
• general blood analysis;
• x-ray.

If a virus infection of the spinal cord or brain is suspected, the patient is prescribed a puncture of the cerebrospinal fluid.

Exanthema treatment

How to treat exanthema? First of all, it is necessary to identify the pathogen and deal with it. The fight against skin elements in this case is symptomatic.

Treatment of exanthema includes mandatory bed rest and taking the following groups of medications:

• antipyretics - Efferalgan, Nurofen, Paracetamol, Maxicold, Ibuklin, Panadol;
• antiseptics - brilliant green, methylene blue;
• vitamins with a high content of vitamin D or Aquadetrim;
• antihistamines - Zodak, Suprastin, Zirtek, Tsetrin;
• antiherpes drugs - Acyclovir, Pencivir, Zovirax, Fenistil, Panavir.

With exanthema, antibiotics should not be taken, since such treatment will not have any effect on the viral nature of the disease. Antimicrobials can be prescribed by a doctor only if bacterial microflora is attached.

Complications

Exanthema is well treated and rarely causes complications. The stronger the patient's immunity, the faster he will recover. The only unpleasant moment can be scratching, through which the infection enters the body. In this case, additional treatment will be required.

Prevention

Specific prophylaxis of exanthema has not yet been developed. As preventive measures, doctors recommend maintaining personal hygiene, strengthening immunity, eating right and fully, and avoiding sick people with fever and skin rashes. Such activities significantly reduce the risk of developing malaise.

In most cases, the outcome of the exanthema is favorable. The disease ends with a complete recovery and the acquisition of permanent immunity. Vaccination against skin lesions is not provided, so prevention and isolation of the patient comes first.

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Almost all babies in the first year of life are faced with a disease such as exanthema. It passes quite quickly, and sometimes pediatricians do not even have time to diagnose it. Of course, when the baby has a fever, accompanied by a rash all over the body, this cannot but disturb the parents. For this reason, you should know the features of this disease and methods for its safe treatment.

What is an exanthema?

Exanthema is a skin disease of infectious etiology, characterized by an acute course. In 80% of cases, the provocateurs of rashes are viruses, and only in 20% - bacteria. The main types of exanthema:

1. viral;
2. enteroviral;
3. sudden.

If you look at the photo, you can see that the rash looks like pinkish or red spots that cover the body of the child. After the baby has been ill with this disease, he develops immunity to an exanthema of an infectious nature.

Features of viral exanthema in children

Viral exanthema in children is a disease characterized by rashes that appear on the skin of a child and evenly cover the entire body. It is common in both toddlers and older children.

Causes of viral exanthema:

• measles virus;
• herpes virus;
• adenovirus;
• chickenpox, etc.

As a rule, the symptoms of exanthema are the same, with the exception of cases of measles or chicken pox. In the course of these diseases, exanthema manifests itself specifically. In this case, complex therapy is used, which is aimed at getting rid of not only the disease, but also exanthema.

Viral and allergic type exanthema are similar in symptoms, so it is very important to recognize in time which pathology a particular type of rash on the baby's skin belongs to (we recommend reading:). Improper treatment of exanthema is fraught with complications.

General clinical picture

Viral exanthema in babies is characterized by an increase in temperature, which usually lasts for 4-5 days. The rash at this time can become more intense under the influence of various factors: bright sunlight, hot water, emotional stress, etc. It is important to protect the child from such phenomena so as not to aggravate the situation.

In newborns, the pulsation of the fontanel may become more frequent. The exanthema that occurs against the background of infection is accompanied by an increase in regional lymph nodes. It is provoked by the following infections:

1. in winter, as a rule, these are rhinovirus diseases, influenza virus and adenoviruses;
2. in summer, enterovirus is more often the causative agent;
3. herpetic infections can be detected at any time of the year (we recommend reading:).

Symptoms depending on the type of virus

Symptoms of viral exanthema in children vary depending on the type of infection. The main symptoms are presented in the table.

Features of enteroviral exanthema in children

Enteroviral (Boston) exanthema is classified as a separate category of exanthema because it is more common than other types of infectious exanthema. Enteroviruses include groups of viruses that cause diarrhea, aseptic meningitis, respiratory diseases, and gastroenteritis. With enteroviral exanthema, the body temperature rises to 39 degrees and intoxication of the body is observed.

The main symptoms of "Boston fever":

1. fever (from 39 degrees and above);
2. intoxication of the body;
3. asymmetrical rashes on the body.

Features of sudden exanthema in children

Sudden exanthema (roseola) is a disease that affects most young children (from six months to 3 years). Children get sick with sudden exanthema mainly in the autumn and winter. Once having been ill with this disease, children develop immunity, which minimizes the possibility of relapse.

Sudden exanthema is transmitted by airborne droplets and through personal contact with a sick person. The incubation period lasts from 5 days to 2 weeks.

The disease begins with an increase in temperature, which gradually increases, reaching high levels (39-40.5 degrees). Fever lasts an average of 3 days, accompanied by manifestations of intoxication (weakness, loss of appetite, vomiting, diarrhea). A characteristic feature of sudden exanthema is that, despite the high temperature, the child does not have catarrhal symptoms (cough, runny nose).

During a fever, the temperature does not keep constantly at a high level. In the morning, it decreases slightly, in the evening it rises again to 39 degrees. In infants, against the background of elevated temperature, a strong pulsation of the fontanel is observed, and febrile convulsions are also possible. This should not cause concern, because. not associated with neurological problems.

As a rule, on the fourth day there is a significant decrease in body temperature in a child. Parents mistake this for recovery, but at the same time, a rash appears on the baby's body.

Pink spots of the rash do not tend to merge, turn pale when pressed, their diameter is from 1 to 5 mm, there is no itching. The rash that accompanies sudden exanthema is not contagious.

After a few days, the rashes on the body completely disappear. In exceptional cases, sudden exanthema is accompanied only by fever, without rash. The child's condition at this time is satisfactory.

Diagnostic methods

Despite the fact that the disease occurs in babies quite often, this disease is rarely diagnosed. The reason is that the symptoms of exanthema disappear in a matter of days, and doctors simply do not have time to diagnose it. However, if the crumbs have a severe fever and rash, then a pediatrician and an infectious disease specialist should be consulted.

During a visual examination, the doctor examines the spots of the rash. In a baby suffering from sudden exanthema, papules on the skin disappear with pressure; with a viral illness, there is no reaction to pressure. If the lighting is bright enough, then you can notice that the elements of the rash slightly rise above the skin.

A blood test is also performed (during exanthema, the number of leukocytes decreases). The doctor necessarily conducts a differential diagnosis. This helps to determine the type of disease and choose the right tactics, how best to treat the baby. Differential diagnosis of exanthema implies the exclusion or confirmation of the following pathologies:

1. measles (we recommend reading:);
2. infectious mononucleosis (we recommend reading:);
3. idiopathic infection;
4. rubella;
5. scarlet fever (we recommend reading:);
6. allergies associated with viral infections.

Features of treatment

Strictly established regimens for the treatment of exanthema do not exist. It is important to isolate a sick child from peers to prevent the spread of the disease. In the room where the sick baby is located, wet cleaning is regularly carried out and the room is ventilated. During a fever, the child is shown to drink plenty of water, walks are allowed only under favorable weather conditions.

If the baby is hard to tolerate high temperature, the doctor may prescribe him antipyretic drugs, and if necessary, antihistamines and antivirals can also be used. With viral exanthema, the child is forbidden to spend a lot of time in the sun, because. this is fraught with itching, and the rash from sun exposure may increase.

Medical therapy

The disease is characterized by an increase in body temperature, therefore, during the illness, drugs with an antipyretic effect are often prescribed:

• ibuprofen;
• Nurofen;
• Paracetamol;
• Panadol.

Antihistamines are used to reduce rash and swelling:

• Zodak;
• Zyrtec;
• Suprastin.

Locally, ointments are applied to the areas affected by the rash: Fenistil, Elokom, La Cree. If you apply the ointment 2-3 times a day, the rash will completely go away within 5 days. When the rash is caused by herpes, ointments are applied that are applied to the site of itching. Acyclovir ointment for herpes has proven itself well. In severe cases of the disease, antiviral drugs are prescribed: Arbidol, Anaferon.

Folk remedies

Folk remedies can also be used in the treatment of a small patient. Before using them, you need to consult a doctor, but, as a rule, there are no contraindications for the use of home infusions and compresses. To improve the general condition of the baby, you can use an infusion of chamomile (pour a tablespoon of dry chamomile with one glass of boiling water).

It is useful to apply fresh potato juice to the areas of the body affected by the rash. Raw peeled potatoes are grated, and the resulting slurry is squeezed out. Juice lubricates the skin covered with a rash 3 times a day. It is useful to bathe the baby in baths with the addition of a decoction of celandine. It helps to reduce rashes, soothes delicate baby skin. Similar baths can be done with the addition of a decoction of fir, chamomile.

The child needs to be given enough to drink. Useful will be cranberry fruit drinks, tea with raspberries and linden. Elder broth has a good effect. To prepare a decoction, pour 180 g of berries with a liter of boiling water, leave for 4-5 hours. Drink the drug should be one glass 3 times a day after meals. The duration of such treatment should be no more than 3 days.

Possible Complications

Complications with exanthema are observed in babies with weak immunity. In 90% of cases, the disease disappears without a trace within 5-10 days. When complications appear, the rash can last for 2-3 weeks, cough and sore throat are also possible, but even in such situations, the symptoms disappear in less than a month.

Unfortunately, sometimes doctors cannot make an accurate diagnosis, mistaking roseola for rubella.

The result of such mistakes is the refusal of parents to vaccinate the child, which can greatly harm him in the future. In rare cases, complications are accompanied by disorders in the work of the cardiovascular system, the appearance of reactive hepatitis and an increase in adenoids.

Preventive actions

Prevention of exanthema is not necessary, because. it occurs once, after which immunity is developed, and the baby subsequently does not suffer from this ailment. General recommendations are to improve and harden the baby to strengthen the immune system, which will allow him to resist various infections and viruses, and if an illness occurs, he will recover quickly.

You should also protect the child from communicating with peers if they have been diagnosed with exanthema. Breastfeeding children are much easier to tolerate roseola. Parents should be vigilant in relation to their child, and in case of suspicion of exanthema, immediately seek help from a doctor.

Every day, local pediatricians in their practice encounter various skin rashes in babies. One of the pathologies that is accompanied by the appearance of a skin rash is exanthema.

What it is?

An acute reaction of the child's body in response to various infections with the appearance of a rubella-like rash on the skin is called exanthema. The prevalence of this childhood disease throughout the world is quite high. Infectious exanthema can occur in both boys and girls. Doctors register quite a lot of cases of the disease in newborns and infants.

Most often in children's practice there is a sudden exanthema. The peak of its incidence falls on the age of 2-10 months.

The first adverse signs occur even in the smallest patients. A specific rash on the skin appears, as a rule, after a very high temperature.

Such an acute reaction of the child's body is due to a bright immune response to the penetration of an infectious agent into it.

Older children and adolescents suffer from this disease much less frequently. In adults, infectious exanthems practically do not occur. Such a high incidence in children is associated with the special functioning of their immune system. The immunity of some babies reacts to various infections quite violently and brightly, which is accompanied by the appearance of specific symptoms of the disease on the skin.

Many years ago doctors used the term "Six Day Sickness" That's what they called sudden exanthema. The essence of this definition is that the clinical symptoms of the disease completely disappear in a sick child on the sixth day. This name is not currently in use. Doctors in some countries use different terminology. They call sudden exanthema roseola infantum, pseudorubella, 3-day fever, roseola infantum.

There is also another, fairly common form of the disease called Boston exanthema. This is an acute pathological condition that occurs in babies as a result of ECHO infection. During the course of the illness, the child develops a macular rash, high fever, and severe symptoms of an intoxication syndrome. Scientists have already identified the causative agents of the disease. These include some subspecies of ECHO viruses (4,9,5,12,18,16) and less commonly Coxsackie viruses (A-16, A-9, B-3).

With Boston exanthema, pathogens enter the baby's body by airborne droplets or alimentary routes (along with food). Cases of the occurrence of Boston exanthema in newborn babies are described. In this case, the infection occurred in utero.

Scientists say that lymphogenous spread of viruses also takes an active part in the development of Boston exanthema.

The reasons

The causative agent of sudden exanthema was identified by scientists at the end of the 20th century. It turned out to be herpes virus type 6. This microorganism was first discovered in the blood of the examined people who suffered from lymphoproliferative diseases. The herpes virus has its main effect on specific cells of the immune system - T-lymphocytes. This contributes to the fact that there are significant violations in the work of immunity.

Currently, scientists have received new results of scientific experiments, which indicate that the type 6 herpes virus has several subtypes: A and B. They differ from each other in molecular structure and virulence properties. It has been scientifically proven that sudden viral exanthema in babies is caused by the herpes virus type B. Subtype A viruses can also have a similar effect, but there are currently no confirmed cases of the disease. After the viruses enter the body, the processes of a violent immune response are triggered, which in some cases proceeds quite violently.

The inflammatory process leads to a strong edema of collagen fibers, dilation of blood vessels, pronounced cell proliferation, and also contributes to the development of characteristic rashes on the skin.

Scientists identify several reasons that can cause signs of infectious exanthema in a child. These include:

What happens in the body?

Most often, babies become infected from each other by airborne droplets. There is another variant of infection - contact-household. Doctors note some seasonality in the development of this disease in children. The peak incidence of infectious exanthems usually occurs in spring and autumn. This feature is largely due to a decrease in immunity during seasonal colds.

Microbes that enter the child's body contribute to the activation of the immune response. It should be noted that after a type 6 herpes infection, many children have strong immunity. Statistically, Most often, babies of the first year of life and children under the age of three are sick. American scientists conducted scientific studies in which they showed that most of the examined apparently healthy people have antibodies to the herpes virus type 6 in their blood. Such a high prevalence indicates the importance of studying the process of formation of infectious exanthems at different ages.

Sources of infection are not only sick babies. They can also become adults who are carriers of the herpes virus type 6.

Doctors believe that infection with this herpes infection occurs only if the disease is in an acute stage, and a person releases viruses into the environment along with biological secrets. A large concentration of microbes is usually found in the blood and saliva.

When viruses enter the child's body and act on T-lymphocytes, a whole cascade of inflammatory immune responses is triggered. First, Ig M appears in the child. These protective protein particles help the child's body recognize viruses and activate the immune response. It is important to note that in newborn babies who are breastfed, the level of Ig M significantly exceeds that of children receiving artificially adapted mixtures as food.

After 2-3 weeks from the onset of the disease, the baby has other protective antibodies - Ig G. An increase in their concentration in the blood indicates that the child's body "remembered" the infection and now "knows it by sight." Ig G can remain for many years, and in some cases even for life.

The peak increase in their concentration in the blood is usually the third week after the onset of the disease. Detection of these specific antibodies is very simple. For this, special serological laboratory tests are carried out. To conduct such an analysis, a venous blood sample is first taken from the baby. The accuracy of the result of a laboratory test is usually at least 90-95%.

For a long time, scientists were worried about the question: is it possible to re-infect (infect) with the virus. In order to find the answer, they conducted a lot of scientific research. Experts have found that the herpes virus type 6 is able to infect and persist in monocytes and macrophages of various body tissues for a long time.

There are even studies confirming that microbes are able to manifest on bone marrow cells. Any decrease in immunity can lead to reactivation of the inflammatory process.

Symptoms

The appearance of a rash on the skin in babies is preceded by an incubation period. For sudden exanthema, it is usually 7-10 days. At this time, as a rule, the baby does not have any signs of the disease. After the end of the incubation period, the child's temperature rises greatly. Its values ​​can reach 38-39 degrees. The severity of the increase in temperature can be different and depends mainly on the initial state of the child.

Very young kids usually endure the disease quite hard. Their body temperature rises to febrile values. Against the background of severe febrile condition, the child, as a rule, has a fever and severe chills. Toddlers become easily excitable, whiny, they do not make contact even with close relatives. The baby's appetite also suffers. During the acute period of illness, children usually refuse to eat, but may beg for "snacks".

The baby has a pronounced increase in peripheral lymph nodes. Most often, the cervical lymph nodes are involved in the process, they become dense to the touch, solder with the skin. Palpation of enlarged lymph nodes can cause pain in the child. The baby has severe nasal congestion and a runny nose. Usually it is slimy, watery. The eyelids swell, the baby's facial expression takes on a somewhat sullen and painful look.

When examining the pharynx, one can notice moderate hyperemia (redness) and looseness of the posterior wall. In some cases, specific areas of maculopapular rash appear on the upper palate and uvula. Such foci are also called Nagayama's spots. After a while, the conjunctiva of the eyes becomes injected. The eyes look painful, in some cases they may even water.

Usually, 1-2 days after the onset of a high temperature, a characteristic sign appears in a child - roseola rash. As a rule, it does not have a special localization and can occur in almost all parts of the body. During a rash on the skin, the temperature continues to rise in the child. In some cases, it rises to 39.5-41 degrees.

However, a distinctive feature of febrile condition with infectious exanthema is that the baby practically does not feel it.

During the entire period of high body temperature, the child's well-being does not suffer much. Many babies remain active despite persistent febrile condition. Usually the temperature returns to normal by 4 or 6 days from the onset of the disease. Infectious sudden exanthema is a very mysterious disease. Even the absence of treatment leads to the fact that the child's condition returns to normal on its own.

The spread of the rash throughout the body usually occurs when the temperature drops. Skin rashes begin to spread from the back to the neck, arms and legs. Loose elements can be different: maculopapular, roseolous or macular. A separate skin element is represented by a small red or pink spot, the size of which is usually does not exceed 3 mm. When pressing on such elements, they begin to turn pale. As a rule, rashes with infectious exanthems do not itch and do not bring any discomfort to the child. It should also be noted that skin rashes practically do not merge with each other and are located at some distance from each other.

In some babies, the rash also appears on the face. Usually loose elements remain on the skin for 1-3 days, after which they disappear on their own. Traces and residual effects on the skin, as a rule, do not remain. In some cases, only a slight redness may remain, which also disappears on its own without the appointment of any special treatment.

It should be noted that infectious exanthema in children under three years of age is much easier than in older children. Doctors note the most severe course of this pathological condition in adolescents.

Their body temperature rises greatly, and their well-being worsens significantly. Paradoxically, infants tolerate high febrile condition with infectious exanthema much easier than schoolchildren.

What does exanthema look like in a baby?

Babies younger than a year often have specific symptoms of this disease. The appearance of a skin rash leads parents to real confusion. A high body temperature in a child makes them think about a viral infection. This leads to the fact that frightened parents urgently call a doctor at home. The doctor usually diagnoses a viral infection and prescribes the appropriate treatment, which does not save the baby from the fact that rashes appear on the skin.

Infectious exanthema is a specific manifestation of an altered reaction of the immune system in response to the ingress of a pathogen. If the baby has individual hypersensitivity, skin rashes will occur even with the use of special antiviral drugs. Many parents ask a reasonable question: is it worth treating? Helping the child's body in the fight against infection is certainly worth it.

Infectious exanthema in a newborn child does not have pronounced clinical features. For 1-2 days from the moment of high temperature, the baby also develops skin rashes. The skin of infants is quite tender and loose. This leads to the fact that the rash spreads over the body quickly enough. A day later, skin rash elements can be found in almost all parts of the body, including the face.

The well-being of the child during a period of high temperature suffers slightly. Some babies may refuse to breastfeed, however, most babies continue to actively eat. One of the manifestations of infection in infants is often the appearance of diarrhea. Usually this symptom is transient and disappears completely when the temperature returns to normal.

The course of the disease in a child under three years of age is the most favorable. Recovery usually occurs 5-6 days after the first adverse symptoms appear.

Many children have a strong immunity for the rest of their lives after an illness. Only in a small number of cases there are repeated cases of reinfection.

The starting point in the appearance of an exacerbation in such a situation, doctors consider a decrease in immunity.

Treatment

Infectious exanthema is one of the few childhood diseases that has the most favorable prognosis. Usually it proceeds quite easily and does not cause any long-term consequences or complications of the disease in the child. Doctors note a severe course of the disease only in children with pronounced manifestations of immunodeficiency states. In this case, to eliminate adverse symptoms, such children undergo a mandatory course of immunostimulating therapy. This specific treatment is prescribed by a pediatric immunologist.

For babies with infectious exanthema, doctors offer a number of recommendations to help improve the child's well-being and speedy recovery. They recommend that the entire acute period of the disease, especially from the moment the rash appears on the skin, the child must be at home. With a high body temperature, the baby is prescribed bed rest. Active walks on the street at this time should be postponed until recovery.

During severe fever, do not wrap the child too tightly. This only contributes to the strong overheating of the baby and disrupts the process of protective natural thermoregulation. Fever with infectious exanthema is curative. It helps the child's body fight viruses. Choose comfortable warm clothes for your child that will protect the baby from hypothermia.

Opinions of doctors about carrying out hygiene procedures are divided. Some experts believe that bathing a baby with infectious exanthema is possible and even contributes to the fact that the child begins to feel much better. Other children's doctors recommend postponing bathing and baths for several days until body temperature returns to normal. The choice of tactics remains with the attending physician who observes the baby. However, the daily toilet of the child can be performed without any restrictions.

The appointment of special antiviral drugs for the treatment of infectious exanthema in children is not required. This condition will pass on its own in a few days.

It is only important to note that, despite the favorable prognosis of the course of the disease, the condition of the baby should be carefully monitored. If you feel unwell, you should definitely contact your doctor.

Prevention

At the present time, unfortunately, scientists have not developed a specific prevention of infectious exanthema. As non-specific preventive measures, doctors recommend observing all the rules of personal hygiene and avoiding any contact with feverish and sick people. During mass outbreaks of infectious diseases in children's educational institutions, quarantine must be introduced. Such measures will significantly reduce the possibility of infection with viral infections and help prevent signs of infectious exanthema from appearing on the baby's skin.

Viral exanthema is a sign of damage to the body by a virus. In children, diseases accompanied by exanthema occur with varying degrees of severity and are accompanied by other signs of an infectious lesion of the body.

Exanthema is any rash that appears on the skin.

The name implies a rash that has a different morphology:

• spots;
• bubbles;
• blisters.

A unified classification of exanthema of infectious origin has not been developed to date. The most convenient is the division of the syndrome into generalized exanthema and local.

Specialists distinguish different degrees of severity of the disease:

Causes of viral exanthema in children

The causes of exanthema is the swelling of collagen fibers as a result of a violent reaction of the immune system to the penetration of the virus into the body.

The prevailing variety of morphological elements of the rash depends on which of the layers of the skin contains the largest number of infectious agents. And this, in turn, depends on the type of virus.

The effect of the disease on the body

Such an acute reaction is due to the high activity of the immune system in childhood. This also explains the fact that in adolescence and older age, when the immune system reacts to infectious agents less violently.

Once in the body and spreading through its tissues with blood flow, the virus interacts with immune cells. It is as a result of this process that an inflammatory reaction occurs, accompanied by swelling of the soft tissues.

Symptoms of viral exanthema in children

Symptoms of diseases depend on the specific pathogen. However, in addition to the specific symptoms that make it possible to diagnose a particular infection, there are also general symptoms that are characteristic of all viral infections accompanied by exanthems.

Viral exanthema in children, the signs of which depend on the virus that provoked the disease, accompanied by the following general symptoms:

The type of skin rash depends on the specific pathogen and may look like this:

In addition to general symptoms, exanthema is accompanied by specific signs characteristic of a particular infection.

In children, the following signs of viral exanthema depend on the specifics of the pathogen:

A maculopapular rash is characteristic of the following diseases:

In addition to polymorphic exanthema, this disease is characterized by:

1. fever reaching 39 degrees for 5 days;
2. inflammation of the sclera;
3. sharp reddening of the tongue (“strawberry tongue”);
4. hyperemia and swelling of the feet and hands, followed by their peeling at the 3rd week of the disease;
5. cervical lymphadenitis with an increase in lymph nodes of more than 1.5 cm.

To make a diagnosis, at least 4 of these signs are required.

Viral exanthema in children, the signs of which are limited to a vesicular rash, is diagnosed with the following diseases:

1. Chicken pox. Characteristic of the course of the disease is high fever and the appearance of a characteristic rash in the form of vesicles against its background. At the same time, in the development of morphological elements in the first 2-4 days of the disease, clearly evolution is traced:

• bubbles;
• pustules;
• crusts.

Characterized by itching in the area of ​​morphological elements of the rash.

2. Viral pemphigus of the mouth and extremities. This syndrome has received the name “mouth-hand-foot syndrome” among clinicians. The causative agent of the pathology is the Coxsackie virus, as well as 71 types of enterovirus.

Most often, this disease occurs in children under 10 years of age. A characteristic feature of this viral infection is seasonality: the greatest number of diseases occurs in autumn and summer. The incubation period after infection lasts 3-4 days. The prodromal period is characterized by fever, fatigue and pain in the throat and nasopharynx.

Subsequently, vesicular rashes appear on the mucous membranes of the cheeks, tongue, palate, gums and lips. On the hands and feet, rashes of a papular nature prevail, which subsequently turn into small vesicles with a diameter of 3 to 7 mm.

Vesicles burst with the formation of erosions, which are characterized by slight soreness. In total, the disease lasts about a week. However, the virus continues to be shed in the stool for several weeks after recovery.

3. Shingles. This disease is a reaction to the varicella-zoster virus. In children under 10 years of age, the thoracic segment is most commonly affected. With age, lesions of the higher segments, up to the scalp, are increasingly observed. The period of rashes lasts up to 5 days.

It is preceded by prodromal phenomena in the form of fever, headache and fatigue. The disease is characterized by pain in the area of ​​localization of rashes, as well as severe pruritus. The clinical picture is so characteristic that, as a rule, laboratory verification of the diagnosis is not required.

Viral exanthema in children, the manifestations of which are diverse, manifests itself in some diseases by the appearance of 3 types of rashes on the skin at once, for example, enterovirus infection.

Typical is a disorder of the digestive function of the gastrointestinal tract. Of the general symptoms, respiratory phenomena are present. Other signs of the disease may be absent.

Diagnosis of viral exanthema in children

The main research methods used to confirm the diagnosis of viral exanthema:

1. General blood analysis. The study reveals a decrease in the number of leukocytes in the blood and an increase in the number of lymphocytes among them (relative lymphocytosis). This is a non-specific analysis; such a picture of the blood is characteristic of an acute viral infection. It does not contribute to the determination of the species of the pathogen.
2. Serological reactions. Such studies are aimed at identifying immunoglobulins in the blood that are specific for a particular disease. The presence of class M immunoglobulin in the blood indicates an acute viral disease.
3. Some diseases require highly specialized research methods, for example, with Kawasaki disease the diagnosis is confirmed by the detection of aneurysms of the coronary arteries using coronary angiography.

In a number of diseases, the diagnosis is based on the features of the clinical picture of the disease. So, for example, it occurs with a typical course of herpes zoster, when external manifestations in combination with local pain are so characteristic that laboratory tests are not required.

Viral exanthema in children, the signs of which are similar to those of allergies, needs a differential diagnosis with rashes of an allergic nature. The key diagnostic feature that allows differentiating viral exanthema from other types of rashes is its localization on the surfaces of the soles and palms.

Parvovirus infection requires differentiation from acute urticaria. The differential diagnostic sign in this case is the weak effectiveness of antihistamines in parvovirus exanthema, or its complete absence.

The differential diagnosis of exanthema provoked by the rubella virus will be facilitated by a specific sign of this disease - an increase in the occipital lymph nodes.

Prevention of viral exanthema in children

Prevention of the spread of viral diseases transmitted by airborne droplets is helped by quarantine measures taken in teams. In addition, immune sera containing specific immunoglobulins, antibodies against a specific pathogen, are administered to persons in contact with the sick.

This method is called passive immunization. When a pathogen enters the body of such a person, it is immediately attacked by antibodies. As a result, a person either does not get sick, or the disease develops in him in a mild form.

Vaccination is also used to prevent the spread of infectious diseases.. A weakened pathogen or its biological material is introduced into the body. In response to such interference, the body produces specific immune proteins.

Their function is to fight the virus during subsequent infection. Vaccination is the only way to fight some infections that cause viral exanthema. One such disease is measles.

Treatment methods for viral exanthema in children

A typical therapeutic regimen used to treat viral diseases, accompanied by skin rashes, is as follows:

As part of symptomatic therapy, the following are used:

Medications

In the treatment of viral diseases accompanied by exanthema, the following drugs are used:

The duration of the use of funds for symptomatic therapy is determined by the severity of symptoms and the dynamics of their regression under the influence of therapeutic agents.

Folk methods

To reduce itching in babies with viral exanthema, baths containing decoctions of medicinal herbs can be used.

An example of such a tool:

1. Prepare decoctions of fir, chamomile and celandine.
2. Add to baby bath.

This composition soothes the inflammatory reaction on the skin, improves the nutrition of the epidermis, which contributes to the speedy healing.

In addition, in order to improve local skin immunity, the following can be used:

• infusions of currant leaves;
• infusion of mint leaves;
• decoction of viburnum;
• rosehip decoction.

Other methods

For a more effective fight against pathogens, immunotherapy is used - the introduction, often intramuscular, into the body of immunoglobulins that fight infectious agents.

To prevent complications in the form of secondary infection of the elements of the rash, they are recommended to be treated with solutions of aniline dyes.

Complications

The most common complication of viral exanthema, accompanied by itching and burning in the area of ​​rash localization, is secondary infection of the elements as a result of scratching. However, some diseases can lead without treatment to more serious complications (secondary encephalitis when infected with the measles virus).

The development of complications in viral exanthema is most likely in people with a weakened immune status. For example, stomatitis and a generalized rash provoked by the herpes simplex virus can be complicated by bacteremia with the subsequent development of purulent arthritis, osteomyelitis, or endocarditis.

Signs of viral exanthema in children can appear against the background of many viral diseases. In order to avoid complications at the first signs of the disease, the child should be shown to a specialist for the correct diagnosis and selection of appropriate therapy.

Article formatting: Mila Fridan

Viral Exam Video

Komarovsky will talk about exanthema in children:

Sudden exanthema- acute viral infection of infants or young children, usually initially manifested by high fever with no local symptoms, followed by the appearance of a rubella-like rash (spotted papular rash). Sudden exanthema is most common in children aged 6 to 24 months, with a median age of about 9 months. Less commonly, older children, adolescents, and adults may be infected. Sudden exanthema has a number of other names: roseola infantum, pseudorubella, sixth disease, 3-day fever, roseola infantum, exanthema subitum, pseudorubella. sudden skin rash. To distinguish sudden exanthema from other childhood diseases with a skin rash, it was once called the "sixth disease" (as it usually became the sixth disease in young children and lasted about six days), but this name is almost forgotten.

What provokes a sudden exanthema:

Sudden exanthema is caused by the herpes virus 6 (HHV-6), which was isolated in 1986 from the blood of people suffering from lymphoproliferative diseases. and less frequently herpesvirus 7 (HHV-7). HHV-6 was first discovered by Salahuddin et al. in 1986 in adult patients with lymphoreticular diseases and infected with the human immunodeficiency virus (HIV). Two years later, Yamanishi et al. isolated the same virus from the blood of four infants with congenital roseola. Although this new virus was originally found in B-lymphocytes of immunocompromised adults, it was subsequently found to have an initial affinity for T-lymphocytes, and its original name, human B-lymphotropic virus (HBLV), was changed to HHV-6. HHV-6 is a member of the genus Roseolovirus, subfamily beta-Herpesvirus. Like other herpes viruses, HHV-6 has a characteristic electron-dense core and an icosahedral capsid surrounded by an envelope and an outer membrane, the site of important glycoproteins and membrane proteins. The main component of the cellular receptor for HHV-6 is CD46, which is present on the surface of all nucleated cells and allows HHV-6 to infect a wide variety of cells. The main target of HHV-6 is the mature CD4+ cell, but the virus can infect natural killer (NK), gamma-delta T lymphocytes, monocytes, dendritic cells, astrocytes and a variety of T and B cell lines, megakaryocytes, epithelial tissue, and others. HHV-6 is represented by two closely related variants, HHV-6A and HHV-6B, which differ in cellular tropism, molecular and biological features, epidemiology, and clinical associations. Roseola and other primary HHV-6 infections are exclusively due to variant B. Cases of primary infection associated with variant A are still to be analyzed. HHV-6A and HHV-6B are most closely related to human herpesvirus type 7 (HHV-7), but some amino acids are similar to human cytomegalovirus (CMV).

Pathogenesis (what happens?) during Sudden exanthema:

Sudden exanthema is spread from person to person, most often by airborne droplets or contact. The peak incidence is spring and autumn. Acquired HHV-6 infection occurs predominantly in infants 6-18 months of age. Almost all children become infected before the age of three and remain immune for life. Most tellingly, HHV-6 infection acquired in childhood results in a high rate of seropositivity in adults. In the United States of America and many other countries, almost all adults are seropositive. The underlying transmission mechanisms of HHV-6 are not well understood. HHV-6 persists after primary infection in blood, respiratory secretions, urine, and other physiological secretions. Apparently, adults, carriers of HHV-6, who are in close contact with them, become the source of infection for infants; other modes of transmission are also possible Relative protection of neonates from primary infection as long as maternal antibodies are present indicates that serum antibodies confer protection against HHV-6. The primary infection is characterized by viremia, which stimulates the production of neutralizing antibodies, which leads to the cessation of viremia. Specific IgM antibodies appear within the first five days from the onset of clinical symptoms, in the next 1-2 months IgM decreases and is not detected in the future. Specific IgM may be present during reactivation of the infection and, as many authors indicate, in a small amount in healthy people. Specific IgGs rise during the second and third weeks, with increasing avidity thereafter. IgG to HHV-6 persist throughout life, but at lower levels than in early childhood. Antibody levels may fluctuate after a primary infection, possibly as a result of latent virus reactivation. A significant increase in the level of antibodies, according to some scientists, is observed in the case of infection with other viruses with similar DNA, such as HHV-7 and CMV. In the observations of some researchers, it is indicated that in children within a few years after the primary infection, a fourfold increase in the titer of IgG to HHV-6 can again occur, sometimes due to acute infection with another agent, and possible reactivation of latent HHV-6 cannot be excluded. The literature describes that reinfection with another variant or strain of HHV-6 is possible. Cellular immunity is important in controlling primary HHV-6 infection and subsequently in maintaining latency. Reactivation of HHV-6 in immunocompromised patients confirms the importance of cellular immunity. The acute phase of primary infection is associated with increased NK cellular activity, possibly through IL-15 and IFN induction. In vitro studies have noted a decrease in viral replication under the influence of exogenous IFN. HHV-6 also induces IL-1 and TNF-α, suggesting that HHV-6 may modulate the immune response during primary infection and reactivation through stimulation of cytokine production. After the primary infection persistence of the virus in a latent state or in the form of a chronic infection with the production of the virus. The components of the immune response important in the control of chronic infection are unknown. Reactivation of the latent virus occurs in immunocompromised patients, but can occur in immunocompetent individuals for unknown reasons. HHV-6 DNA is often found after primary infection in peripheral blood mononuclear cells and secretions from healthy individuals, but the main location of latent HHV-6 infection is unknown. Experimental studies conducted by scientists indicate that HHV-6 latently infects monocytes and macrophages of various tissues, as well as bone marrow stem cells, from which it subsequently reactivates.

Symptoms of sudden exanthema:

The disease is not very contagious, the incubation period of the disease is 9-10 days. Signs and symptoms of HHV-6 (or HHV-7) infection may vary depending on the patient's age. In young children, the temperature usually rises suddenly, irritability, enlargement of the cervical and occipital lymph nodes, runny nose, swelling of the eyelids, diarrhea, a small injection in the throat, sometimes exanthema in the form of a small maculopapular rash on the soft palate and tongue (Nagayama "s spots), redness and swelling of the conjunctiva of the eyelids A rash develops within 12 to 24 hours of a fever Older children who develop an HHV-6 (or HHV-7) infection most often have symptoms such as high fever for several days , possible runny nose and/or diarrhea Older children are less likely to develop a rash The temperature during fever can be quite high, averaging 39.7 C, but can rise as high as 39.4-41.2 C. Despite the high temperature, the child is usually active The temperature drops critically, usually on day 4. Exanthema appears when the temperature drops. Sometimes the rash occurs before the fever subsides, sometimes after The child had no fever during the day. Rashes of a roseolous, macular or maculopapular nature, pink in color, up to 2-3 mm in diameter, they turn pale when pressed, rarely merge, are not accompanied by itching. Rashes usually appear immediately on the trunk with subsequent spread to the neck, face, upper and lower extremities, in some cases they are located mainly on the trunk, neck and face. Rashes persist for several hours or for 1-3 days, disappear without a trace, sometimes there is exanthema in the form of erythema. Primary HHV-6 infection in neonates also presents with sudden exanthema. It can be observed in children of the first three months of life, including newborns, its clinical manifestations are generally similar to those in older children, but are milder. Fever without local symptoms is the most common form, but fever is usually lower than in older children. According to the literature, a more frequent manifestation of primary HHV-6 infection is asymptomatic infection, in which HHV-6 DNA is detected in peripheral blood mononuclear cells after birth or in the neonatal period. In some patients, HHV-6 DNA persists in peripheral blood cells for some time, followed by the development of a manifest primary HHV-6 infection. HHV-6 infection has been associated with a variety of manifestations. Some scientists suggest HHV-6 as the cause of chronic fatigue syndrome, others - multiple sclerosis, multiple organ failure syndrome, pink lichen, hepatitis, viral hemophagocytosis, idiopathic thrombocytopenic purpura, hypersensitivity syndrome to drugs, especially antibacterial. However, these data are controversial and require further in-depth study. Complications of sudden exanthema Complications are rare with sudden exanthema, except in children with a reduced immune system. People with healthy immune systems generally develop lifelong immunity to HHV-6 (or HHV-7).

Diagnosis of sudden exanthema:

Blood test: leukopenia with relative lymphocytosis Serological reactions: detection of IgM, IgG to HHV type 6 (HHV-6) Serum PCR for HHV-6. Differential Diagnosis: rubella, measles, infectious erythema, enterovirus infection, otitis media, meningitis, bacterial pneumonia, drug rash, sepsis.

Treatment for sudden exanthema:

Do I need to see a doctor if a child has a sudden exanthema? Yes, that's a good idea. A child with a fever and rash should not be in contact with other children until they have been seen by a doctor. After the disappearance of the rash and fever, the child can return to normal life. Fever treatment If the temperature does not cause discomfort to the child, then treatment is not needed. It is not necessary to wake the child to treat a fever unless instructed by a doctor. A child with a fever should be kept comfortable and not dressed too warmly. Excess clothing can cause a fever. Bathing in warm water (29.5 C) may help reduce fever. Never rub a child (or adult) with alcohol; alcohol vapors can cause numerous problems if inhaled. If the child is trembling in the bath, the temperature of the bath water should be increased. High temperature with sudden exanthema can initiate seizures. Fibrillary seizures are common among children 18 months to 3 years of age. They occur in 5-35% of children with sudden exanthema. Seizures can look very frightening, but are usually not dangerous. Fibrillary seizures are not associated with long-term side effects, damage to the nervous system or brain. Anticonvulsants are rarely prescribed to treat or prevent fever. What to do if the child has convulsions due to sudden exanthema fever: - Remain calm and try to calm the child, loosen the clothing around the neck. - Remove sharp objects that can cause harm, turn the child on its side, so saliva can flow out of the mouth. - Place a pillow or rolled-up coat under the baby's head, but do not put anything in the baby's mouth. - Wait for the cramps to pass. Children are often drowsy and may sleep after seizures, which is quite normal. After convulsions, you need to see a doctor so that the child is sure to be examined. A sudden exanthema rash appears when the elevated temperature (fever) subsides. The rash appears on the neck and trunk, especially in the abdomen and back, but can also appear on the arms and legs (limbs). The skin takes on a reddish color and temporarily turns pale when pressed. The rash does not itch or hurt. She is not contagious. The rash resolves in 2-4 days and does not return. The prognosis is favorable.

Prevention of sudden exanthema:

Prevention not developed; the patient is recommended to be isolated until the disappearance of the clinical manifestation of the disease.