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Prepared by...
Virat Sirisanthana, M.D. |
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Department of Pediatrics,
Chiang Mai University
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| An 7-month-old infant was brought to the Emergency Room of CMU hospital: |
| CC: High
fever for 2 days PI: He has been healthy until 2 days prior to admission he developed high fever and was seen in the ER once. Today he still has high fever with bulging of the anterior fontanelle. |
| PE: VS:
Temp 39 C, PR 128/min, RR 40/mim HEENT: mild injected pharynx Chest + Abdomen : WNL Nervous system: moderate bulging of anterior fontanelle, no stiff neck, no neurological deficit. |
| Laboratory investigations: CBC: Hb 10.6 mg, Hct 36.3%, WBC 14,600 (N 42%, L 48%, M 9%), platelet count 261,000 PBS:NCNC,toxic and vac 1+,atypical lymp 5% |
| Course in the hospital: He was given symptomatic and supportive care. Antibiotic was not given. The fever subsided on the second hospitalized day with the appearence of discreat maculopapular rash (more at the trunk) as shown in the figure. |
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| Diagnosis : Roseola infantum (Exanthem subitum) or HHV-6 infection | |
| Ref: Steve Kobl. Human Herpesvirus 6. In Nelson WE, Behrman RE, Kliegman RM, Arvin AM. eds. Textbook of Pediatrics 15th ed. W.B. Saunders Company, 1996;890-2. | |