Pediatric Neurology
Volume 41, Issue 5 , Pages 353-358 , November 2009

Exanthem Subitum-Associated Encephalitis: Nationwide Survey in Japan

  • Tetsushi Yoshikawa, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • Corresponding Author InformationCommunications should be addressed to: Dr. Yoshikawa; Department of Pediatrics; Fujita Health University School of Medicine; Toyoake, Aichi 4701192, Japan.
    • ,
  • Masahiro Ohashi, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Fumi Miyake, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Ayano Fujita, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Chie Usui, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Ken Sugata, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Sadao Suga, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Shuji Hashimoto, PhD

      Affiliations

    • Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
    • ,
  • Yoshizo Asano, MD

      Affiliations

    • Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

Received 7 February 2009 ,Accepted 11 May 2009.

References 

  1. Yamanishi K, Okuno T, Shiraki K, et al. Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet. 1988;1:1065–1067
  2. Asano Y, Yoshikawa T, Suga S, et al. Clinical features of infants with primary human herpesvirus 6 infection (exanthem subitum, roseola infantum). Pediatrics. 1994;93:104–108
  3. Ishiguro N, Yamada S, Takahashi T, et al. Meningo-encephalitis associated with HHV-6 related exanthem subitum. Acta Paediatr Scand. 1990;79:987–989
  4. Asano Y, Yoshikawa T, Kajita Y, et al. Fatal encephalitis/encephalopathy in primary human herpesvirus-6 infection. Arch Dis Child. 1992;67:1484–1485
  5. Yoshikawa T, Nakashima T, Suga S, et al. Human herpesvirus-6 DNA in cerebrospinal fluid of a child with exanthem subitum and meningoencephalitis. Pediatrics. 1992;89:888–890
  6. Suga S, Yoshikawa T, Asano Y, et al. Clinical and virological analyses of 21 infants with exanthem subitum (roseola infantum) and central nervous system complications. Ann Neurol. 1993;33:597–603
  7. Oki J, Yoshida H, Tokumitsu A, et al. Serial neuroimages of acute necrotizing encephalopathy associated with human herpesvirus 6 infection. Brain Dev. 1995;17:356–359
  8. Ueda T, Miyake Y, Imoto K, et al. Distribution of human herpesvirus 6 and varicella-zoster virus in organs of a fatal case with exanthem subitum and varicella. Acta Paediatr Jpn. 1996;38:590–595
  9. Webb DW, Bjornson BH, Sargent MA, Hukin J, Thomas EE. Basal ganglia infarction associated with HHV-6 infection. Arch Dis Child. 1997;76:362–364
  10. Yoshikawa T, Asano Y. Central nervous system complications in human herpesvirus-6 infection. Brain Dev. 2000;22:307–314
  11. Takanashi J, Barkovich AJ, Tada H, Takada N, Fujii K, Kohno Y. Cortical liquefaction in severe human herpesvirus 6 encephalopathy. Neurology. 2006;66:452–453
  12. Yoshinari S, Hamano S, Minamitani M, Tanaka M, Eto Y. Human herpesvirus 6 encephalopathy predominantly affecting the frontal lobes. Pediatr Neurol. 2007;36:13–16
  13. Nagasawa T, Kimura I, Abe Y, Oka A. HHV-6 encephalopathy with cluster of convulsions during eruptive stage. Pediatr Neurol. 2007;36:61–63
  14. Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children. A prospective study of complications and reactivation. N Engl J Med. 1994;331:432–438
  15. Suga S, Suzuki K, Ihira M, et al. Clinical characteristics of febrile convulsions during primary HHV-6 infection. Arch Dis Child. 2000;82:62–66
  16. Ahtiluoto S, Mannonen L, Paetau A, et al. In situ hybridization detection of human herpesvirus 6 in brain tissue from fatal encephalitis. Pediatrics. 2000;105:431–433
  17. Saito Y, Sharer LR, Dewhurst S, Blumberg BM, Hall CB, Epstein LG. Cellular localization of human herpesvirus-6 in the brains of children with AIDS encephalopathy. J Neurovirol. 1995;1:30–39
  18. Ablashi DV, Lusso P, Hung CL, et al. Utilization of human hematopoietic cell lines for the propagation and characterization of HBLV. (human herpesvirus 6). Int J Cancer. 1988;42:787–791
  19. Albright AV, Lavi E, Black JB, Goldberg S, O'Connor MJ, Gonzalez-Scarano F. The effect of human herpesvirus-6 (HHV-6) on cultured human neural cells: oligodendrocytes and microglia. J Neurovirol. 1998;4:486–494
  20. De Filippis L, Foglieni C, Silva S, Vescovi AL, Lusso P, Malnati MS. Differentiated human neural stem cells: A new ex vivo model to study HHV-6 infection of the central nervous system. J Clin Virol. 2006;37(Suppl. 1):S27–S32
  21. He J, McCarthy M, Zhou Y, Chandran B, Wood C. Infection of primary human fetal astrocytes by human herpesvirus 6. J Virol. 1996;70:1296–1300
  22. Yoshikawa T, Asano Y, Akimoto S, et al. Latent infection of human herpesvirus 6 in astrocytoma cell line and alteration of cytokine synthesis. J Med Virol. 2002;66:497–505
  23. Ward KN, Andrews NJ, Verity CM, Miller E, Ross EM. Human herpesviruses-6 and -7 each cause significant neurological morbidity in Britain and Ireland. Arch Dis Child. 2005;90:619–623
  24. Hashimoto S, Fukutomi K, Nagai M, et al. Response bias in the nationwide epidemiological survey of an intractable disease in Japan. J Epidemiol. 1991;1:27–30
  25. Tanaka K, Kondo T, Torigoe S, Okada S, Mukai T, Yamanishi K. Human herpesvirus 7: Another causal agent for roseola (exanthem subitum). J Pediatr. 1994;125:1–5
  26. Asano Y, Suga S, Yoshikawa T, Yazaki T, Uchikawa T. Clinical features and viral excretion in an infant with primary human herpesvirus 7 infection. Pediatrics. 1995;95:187–190
  27. Yoshikawa T, Suga S, Asano Y, Yazaki T, Kodama H, Ozaki T. Distribution of antibodies to a causative agent of exanthem subitum (human herpesvirus-6) in healthy individuals. Pediatrics. 1989;84:675–677
  28. Friedman JH, Golomb J, Aronson L. Hemiplegia associated with roseola infantum (exanthum subitum). NY State J Med. 1950;50:1749–1750
  29. Yanagihara K, Tanaka-Taya K, Itagaki Y, et al. Human herpesvirus 6 meningoencephalitis with sequelae. Pediatr Infect Dis J. 1995;14:240–242
  30. Drobyski WR, Knox KK, Majewski D, Carrigan DR. Brief report: Fatal encephalitis due to variant B human herpesvirus-6 infection in a bone marrow-transplant recipient. N Engl J Med. 1994;330:1356–1360
  31. Bosi A, Zazzi M, Amantini A, et al. Fatal herpesvirus 6 encephalitis after unrelated bone marrow transplant. Bone Marrow Transplant. 1998;22:285–288
  32. De Almeida Rodrigues G, Nagendra S, Lee CK, De Magalhaes-Silverman M. Human herpes virus 6 fatal encephalitis in a bone marrow recipient. Scand J Infect Dis. 1999;31:313–315
  33. Singh N, Paterson DL. Encephalitis caused by human herpesvirus-6 in transplant recipients: Relevance of a novel neurotropic virus. Transplantation. 2000;69:2474–2479
  34. Asano Y, Yoshikawa T, Suga S, et al. Viremia and neutralizing antibody response in infants with exanthem subitum. J Pediatr. 1989;114:535–539
  35. Baskin HJ, Hedlund G. Neuroimaging of herpesvirus infections in children. Pediatr Radiol. 2007;37:949–963

 This work was presented in part at the 45th Annual Infectious Diseases Society of America, San Diego, California, October 4-7, 2007.

PII: S0887-8994(09)00311-7

doi: 10.1016/j.pediatrneurol.2009.05.012

Pediatric Neurology
Volume 41, Issue 5 , Pages 353-358 , November 2009

Article Tools