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Sesta malattia: cause, diagnosi e sintomi


 

malattie che si manifestano nei primi mesi di vita

 

Che cos’è la sesta malattia?

 

La sesta malattia (roseola infantum, esantema subitum, esantema infantum, esantema critico)  è una patologia virale causata da due virus:

  • herpesvirus umano (HHV) di tipo 6,
  • herpesvirus umano (HHV) di tipo 7

L”infezione primaria si verifica precocemente nel corso della vita e il neonato è di regola protetto dagli anticorpi materni (più del 90% dei neonati è sieropositiva per Ab anti HHV6), e ciò riflette il passaggio transplacentare. Il picco di acquisizione della sesta malattia da HHV6, tra i 6 e i 15 mesi di vita, corrisponde alla scomparsa degli anticorpi materni e generalmente viene infettato dagli stessi genitori (la madre  prima lo protegge e successivamente lo infetta).

Come avviene il contagio?

 

Il virus entra nell’ospite attraverso la mucosa congiuntivale, nasale e orale, le gocce vengono espulse quando il soggetto infetto parla, starnutisce o tossisce, con successiva viremia soprattutto nelle cellule mononucleate del sangue periferico. Dopo l’infezione acuta, il virus si stabilisce in forma latente all’interno dei monociti delle ghiandole salivari, rene, polmone e  SNC.

 

Diagnosi

La diagnosi di sesta malattia è fondamentalmente clinica e si basa sull’osservazione dei segni tipici della malattia, indicativo è il tempo trascorso tra la comparsa della febbre e la comparsa dell’esantema.

Sintomi

 

La sesta malattia (roseola) è una malattia esantematica che si presenta con febbre di grado elevato tipica dei primi anni di vita. Il periodo prodromico è generalmente asintomatico o caratterizzato da lievi sintomi  delle alte vie respiratorie. La malattia sintomatica è generalmente preannunciata dalla comparsa di:

  • febbre elevata (fino a 39-40) che persiste per 3/5 giorni e poi si risolve tipicamente in modo brusco per crisi.
  • Entro le prime 24-48 ore di febbre il numero di leucociti è elevato, spesso con aumento di neutrofili.
  • Dal secondo-terzo giorno di febbre si assiste ad una riduzione dei globuli bianchi determinando a volte neutropenia.
  • Il rash (eruzione cutanea) compare entro 12 -24 ore dalla risoluzione della febbre, si verifica in non più del 20% dei casi; si presenta rosa chiaro, non confluente, a piccoli elementi (no  vescicole, no pustole) che inizia a livello del tronco e si diffonde a collo e parte prossimale delle estremità.


Convulsioni

La sesta malattia è la causa più comune di convulsioni febbrili in questa fascia di età (10 /5% dei casi) e rappresenta la causa più nota di febbre senza focolaio nell’anno di vita.

I segni che caratterizzano le convulsioni sono:

  • stato di incoscienza
  • spasmi di gambe e braccia per qualche minuto e gesti incontrollati
  • incontinenza fecale o/e urinaria

Terapia

La roseola è una malattia autolimitante che non richiede trattamento. Gli antipiretici possono essere utili per controllare la febbre e ridurre il rischio di convulsione febbrile.

 

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Broncopolmonite nei bambini 

Trisomia 13-Sindrome di Patau

 

Quarta malattia-Wikipedia 

Risultati immagini per quarta malattia wikipedia


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