DIEBACK SUDDEN (exanthema subitum; Greek exanthema rash, rash; synonym: the erythema is a sudden, sixth disease) — the acute infectious disease of children of early age which is characterized by rise in temperature with the subsequent emergence of a menocelis.
It is described in 1910. J. Zahorsky.
The etiology is unknown. The virus nature of a disease is supposed, however the virus is not established. Nek-ry researchers emergence E. connect with an adenoviral infection century, others consider an infestant enteroviruses (see. Intestinal viruses).
The epidemiology is not studied. The disease meets in the form of sporadic cases and small flashes. Contageousness of patients low. Nek-ry researchers assume existence in considerable number of cases the carriage of the activator is hidden the proceeding forms, and also. Children under 3 years are ill preferential; the disease meets more often in the spring and in the fall.
Her II atologoanatomichesky picture is studied.
The incubation interval makes 3 — 7 days, sometimes up to 17 days more often. The disease is characterized by sudden rise in temperature to ■39 — 40 ° at rather small disturbance of the general state. At the child the concern, sleeplessness, a loss of appetite and a diarrhea can be observed. At babies at very high temperature spasms are possible. For the 4th day temperature sharply falls. Almost at the same time rash in the form of light pink spots to dia develops. 2 — 5 mm, nek-ry of them are surrounded with a pale nimbus. Rashes usually at first develop on spin, and then quickly extend to a stomach, a breast and extensor surfaces of extremities. On a face rash is, as a rule, poorly expressed or at all is absent. In 2 — 3 days rash disappears, without leaving pigmentation. The small peeling is occasionally noted. The cases of a disease proceeding without rash are described. Poorly expressed catarral phenomena from upper respiratory tracts can be observed and conjunctivitis, sometimes — increase cervical limf, nodes and a spleen.
By the time of temperature drop emergence of a leukopenia (to 3000 — 4000 in 1 mkl blood), neytro-pegsh, a relative lymphocytosis (to 80 — 90%) and a monocytosis is characteristic. The picture of blood is normalized in several days. Exceptional cases of a meningism (see), serous meningitis are described (see) and encephalomeningitis.
The diagnosis is established on the basis of characteristic by a wedge, pictures. Differential diagnosis is carried out with scarlet fever (see), to a bark (see) and a rubella (see), at to-rykh at first there is rash, then temperature increases, and also there are signs typical for these diseases (Velsky's spots — Filatova — To ori of a face, the expressed catarral phenomena and an etatshost of a rash at measles; quinsy and change of language at scarlet fever; zadnesheyny lymphadenitis at a rubella). It is slightly more difficult to distinguish century from medicinal rash (see Lekar a stvenny allergy). In this case at diagnosis consider anamnestic data, changes of a picture of blood.
Prevention is not developed; the patient recommend to isolate before disappearance a wedge, displays of a disease.
Bibliography: Viral and rikketepozny infections of the person, under the editorship of T. Rivers, the lane with English, page 545, M., 1955; Ivanov A. I. Infectious diseases from ekzantema, L., 1970, bibliogr.; Infectious
diseases, under the editorship of M. Voykuleeka, the lane from
Romanians., t. 1, page 254, Bucharest, 1963; The Guide to droplet infections, under the editorship of I. K. Musabayev, page 509, Tashkent, 1982; KrugmanS. KatzS. L. Infectious diseases of children, St Louis a.o., 1981; Zahorsky J.
Roseola in fantilis, Pediatrics, v. 22, p. 60, 1910.
S. D. Nosov.