Human herpesvirus 6 (Roseola)

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Human herpesvirus 6 (Roseola)

Pathology

Pigmented skin disorders

Vitiligo

Albinism

Acneiform skin disorders

Acne vulgaris

Folliculitis

Rosacea

Hidradenitis suppurativa

Papulosquamous and inflammatory skin disorders

Contact dermatitis

Atopic dermatitis

Lichen planus

Pityriasis rosea

Psoriasis

Seborrhoeic dermatitis

Urticaria

Keratotic skin disorders

Actinic keratosis

Vesiculobullous skin disorders

Epidermolysis bullosa

Bullous pemphigoid

Pemphigus vulgaris

Desquamating skin disorders

Erythema multiforme

Stevens-Johnson syndrome

Skin integrity disorders

Pressure ulcer

Sunburn

Burns

Frostbite

Skin infections

Cellulitis

Erysipelas

Impetigo

Necrotizing fasciitis

Human papillomavirus

Varicella zoster virus

Poxvirus (Smallpox and Molluscum contagiosum)

Coxsackievirus

Herpes simplex virus

Candida

Malassezia (Tinea versicolor and Seborrhoeic dermatitis)

Pediculus humanus and Phthirus pubis (Lice)

Sarcoptes scabiei (Scabies)

Human herpesvirus 6 (Roseola)

Parvovirus B19

Varicella zoster virus

Measles virus

Rubella virus

Skin neoplasms

Vascular tumors

Human herpesvirus 8 (Kaposi sarcoma)

Angiosarcomas

Skin cancer

Hair and nail disorders

Alopecia areata

Telogen effluvium

Onychomycosis

Integumentary system pathology review

Pigmentation skin disorders: Pathology review

Acneiform skin disorders: Pathology review

Papulosquamous and inflammatory skin disorders: Pathology review

Vesiculobullous and desquamating skin disorders: Pathology review

Bacterial and viral skin infections: Pathology review

Skin cancer: Pathology review

Viral exanthems of childhood: Pathology review

Assessments

Human herpesvirus 6 (Roseola)

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Human herpesvirus 6 (Roseola)

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Questions

USMLE® Step 1 style questions USMLE

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An 8-month-old boy is brought to the office for the evaluation of a rash. It started 2 days ago on the neck and trunk and then spread to the face and extremities. The patient had an emergency department visit 3 days ago because of a generalized-tonic clonic seizure. At that time, he had a temperature of 40°C (104°F). Today, temperature is 37°C (98.6°F), pulse is 95/min, respirations are 30/min and blood pressure is 90/55 mmHg. Physical examination shows a blanching maculopapular rash that is most prominent on the neck, trunk, and buttocks.  A virus from which of the following classes is the most likely cause of this patient’s disease? 

External References

First Aid

2022

2021

2020

2019

2018

Human herpesvirus 6 (HHV-6) p. 162, 178

External Links

Transcript

Content Reviewers

Viviana Popa, MD

Contributors

Alexandru Duhaniuc, MD

Evan Debevec-McKenney

Human herpesvirus 6, or HHV-6, is a double stranded DNA virus which belongs to the Herpesviridae family, subfamily Betaherpesvirinae, genus Roseolovirus. HHV-6 primary infection is the cause of the common childhood disease called roseola infantum, also known as exanthema subitum or sixth disease.

Human herpesvirus 6 is a double stranded linear DNA virus surrounded by an icosahedral capsid, which is a spherical protein shell made up of 20 equilateral triangular faces.

The capsid is covered by a protein layer called the tegument, and finally enclosed in an envelope, which is a lipid membrane that contains viral glycoproteins and is acquired from the nuclear membrane of host cells.

Now, HHV-6 infection begins when a person comes in contact with respiratory secretions from another person who contains the virus.

Once in the body, the virus attaches to dendritic cells, which are antigen-presenting cells that can be found in the skin, nose, lungs, stomach and intestines.

These cells are able to process antigens like viral proteins and present them on the cell surface to the T cells.

So, when the virus attaches to dendritic cells, it activates them, and they migrate to the lymph nodes where they interact with CD4+ T lymphocytes.

When dendritic cells and T cells interact, the virus gets ingested by T cells and they get infected.

Inside T cells, the virus can replicate most efficiently, so it undergoes the lytic cycle, where its DNA gets transcribed and translated by cellular enzymes, to form viral proteins, which are packaged into new viruses that can leave the cell destroyed and subsequently infect neighboring cells.

The virus can also replicate into a wide variety of other cells such as monocytes, macrophages, natural killer cells, astrocytes, megakaryocytes and glial cells - but not as efficiently as inside T cells.

Summary

Human herpesvirus 6 (HHV-6) is a double-stranded DNA virus of the Herpesviridae family, known to cause roseola. Roseola is transmitted through contact with respiratory secretions of a sick person. The infection has two phases; a febrile phase characterized by a sudden onset of fever associated with respiratory symptoms and lymphadenopathy around the neck, and an exanthem phase characterized by a decrease in the body temperature and patchy exanthem (eruptive skin rashes)

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