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Twenty-one infants who had virologically confirmed exanthem subitum and central nervous system(CNS)complications were studied to elucidate the clinical features,laboratory and virological findings,and outcome.The primary infection with human herpes virus 6 was confirmed by isolation of the virus from blood,a significant rise in the antibody titers to the virus,or both.All convulsive seizures(15 generalized and 6 focal)occurred during the pre-eruptive stage of exanthem subitum.Four infants with encephalitis/encephalopathy had more severe clinical features with abnormalities demonstrated on electroencephalograms and cerebral computed tomograms.All infants except those with encephalitis/encephalopathy recovered without any sequelae.One infant with encephalitis/encephalopathy developed epilepsy and another one died.Human herpes virus 6 DNA amplified by the nested polymerase chain reaction method was detected in the cerebrospinal fluid of 6 infants,including 3 with encephalitis/ encephalopathy,of 11 patients examined by the fifth day of the illness. These findings suggest that CNS complications including encephalitis/ encephalopathy occur at the pre-eruptive stage of exanthem subitum,that human herpes virus 6 invades the CNS in some patients,and that the outcome is not always benign. |
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