Management of patients with upper respiratory tract infections accompanied by Exanthem Subitum

Abstract

Abstract. The objective of this study was to conduct a comprehensive analysis of the clinical features, pathophysiological mechanisms, and therapeutic approaches to the management of Exanthem Subitum (also known as roseola infantum) in children. The study included 250 pediatric patients presenting with symptoms of upper respiratory infections, among whom 5 children (2%) were diagnosed with Exanthem Subitum. The most vulnerable group was identified as children aged 6 months to 2 years (85% of cases), attributed to the waning of maternal immunity and the immaturity of the child’s own immune system. It was found that 78% of affected children attended organized childcare facilities, indicating that close contact in such environments contributes to the spread of HHV-6 and HHV-7 viruses, particularly during spring and autumn (72% of cases), when immune resistance is typically lower.The clinical course in all diagnosed cases featured a sudden onset of high fever (39–40°C) lasting 3–5 days, followed by a rapid temperature drop and the appearance of a maculopapular rash, predominantly on the trunk, face, and limbs. Most children did not report any discomfort such as itching or pain (95%), and the rash resolved within 1–3 days. A preceding acute respiratory viral infection was noted in 65% of cases, suggesting a link with temporary immune suppression. Additional risk factors included lack of breastfeeding until 6 months of age (70%), genetic predisposition (40%), and first-time exposure to the virus.Treatment is exclusively symptomatic. The primary therapeutic measures include antipyretics (paracetamol, ibuprofen), adequate hydration, physical cooling methods, and maintaining optimal environmental conditions. Educating parents about the natural course of the disease, appropriate care strategies, and warning signs requiring medical attention is essential. Healthcare professionals are advised to increase awareness of Exanthem Subitum’s clinical signs and apply differential diagnostic protocols to distinguish it from other exanthematous diseases.The findings underscore the importance of a comprehensive approach to diagnosing, managing, and preventing Exanthem Subitum. This includes hygienic, educational, and organizational interventions aimed at reducing incidence and preventing complications.