Kn. Ward et Jj. Gray, PRIMARY HUMAN HERPESVIRUS-6 INFECTION IS FREQUENTLY OVERLOOKED AS A CAUSE OF FEBRILE FITS IN YOUNG-CHILDREN, Journal of medical virology, 42(2), 1994, pp. 119-123
Sera from 248 children aged 30-179 weeks were tested retrospectively f
or human herpesvirus-6 (HHV-6) IgG antibody avidity. Twenty-five child
ren presented with febrile fits, in one case with a rash, exanthem sub
itum resulting from prima ry HHV-6 infection was diagnosed at the time
, but in the others HHV-6 was not considered in the differential diagn
osis even though two patients had a rash. In fact, five of the 25 pati
ents experienced primary infection as shown by low avidity HHV-6 antib
ody. Although nine other of these patients were seronegative in the ac
ute phase of the illness, and unfortunately convalescent sera were not
available to confirm primary HHV-6 infection, seronegativity was clea
rly a risk factor for febrile fits (P = 0.03, odds ratio 3.14 for all
children; P = 0.002, odds ratio 7.20 for children aged 70-179 weeks),
and primary HHV-6 infection was a very likely diagnosis. The remaining
11 children had high avidity antibody, so HHV-6 was excluded as a cau
se of their febrile fits. HHV-6 may frequently be a cause of febrile f
its, often without the typical rash of exanthem subitum, and this diag
nosis is often overlooked by clinicians, (C) 1994 Wiley-Liss, Inc.