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Pediatr Infect Dis J. 2019 Jun 20. doi: 10.1097/INF.0000000000002379. [Epub ahead of print]

Clinical Characteristics of Primary HHV-6B Infection in Children Visiting the Emergency Room.

Author information

1
From the Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Aichi, Japan.
2
Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.
3
Department of Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan.

Abstract

OBJECTIVE:

This cohort study, based on the design of a prior study in the United States, was conducted to elucidate the clinical features of primary human herpesvirus-6B (HHV-6B) infection.

METHODS:

Between June 2014 and May 2016, febrile children younger than 5 years who visited the emergency room (ER) and underwent blood examination were enrolled in this study.

RESULTS:

Fifty-nine (12%) of the 491 patients were diagnosed with primary HHV-6B infection. The rates of both simple and complex febrile seizure were significantly higher in patients with primary HHV-6B infection than in those without (P < 0.001 and P = 0.008, respectively). The median age at primary HHV-6B infection was 15 months. Forty-seven (79.7%) of the 59 patients with primary HHV-6B infection were younger than 2-year-old. Clinical features were compared between HHV-6B-infected patients older and younger than 2 years. The frequency of apparent infection (exanthema subitum) was significantly higher in the younger patients (P = 0.01). The median leukocyte (P = 0.01) and lymphocyte (P < 0.001) counts in the patients older than 2 years were significantly lower than those in the younger patients.

CONCLUSIONS:

Primary HHV-6B infection accounted for 12% of ER visits. Secondary febrile seizures, in particular the complex type, were considered to be a major contributor to the disease burden of primary HHV-6B infection. The timing of primary HHV-6B infection occurred at older ages than in past reports, and the frequency of inapparent infection was higher in older patients.

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