From the Guidelines
Viral exanthems (rashes) in pediatric patients are most commonly caused by enteroviruses, adenoviruses, and childhood illnesses like chickenpox, measles, or roseola, as well as respiratory viruses such as respiratory syncytial virus (RSV) and influenza 1. The causes of viral exanthems in pediatric patients can be diverse, but the most common ones include:
- Enteroviruses
- Adenoviruses
- Childhood illnesses like chickenpox, measles, or roseola
- Respiratory viruses such as RSV and influenza It is essential to note that the provided evidence does not directly address the question of viral exanthems, but rather touches on various viral infections and their manifestations in pediatric patients. However, based on the available information and general medical knowledge, it can be inferred that viral exanthems in pediatric patients are often caused by common viral infections. The management of viral exanthems typically involves supportive care, such as:
- Symptom relief with acetaminophen or ibuprofen
- Keeping the child well-hydrated
- Using lukewarm baths or cool compresses for itching
- Applying calamine lotion to irritated areas
- Avoiding harsh soaps and dressing the child in loose, cotton clothing Medical attention is necessary if the rash is accompanied by high fever, appears purple or doesn't blanch when pressed, or if the child seems very ill or shows signs of dehydration. These symptoms could indicate more serious conditions like meningitis or sepsis. It is crucial to prioritize the child's morbidity, mortality, and quality of life when managing viral exanthems, and to seek medical attention if there are any concerns about the child's condition. The most recent and highest-quality study on this topic is not directly available, but based on the provided evidence and general medical knowledge, the above recommendations can be made. In particular, the study by 1 provides valuable information on the management of suspected viral encephalitis in children, which can be relevant to the management of viral exanthems. However, it is essential to consult the most recent and highest-quality evidence available to make informed decisions about the management of viral exanthems in pediatric patients.
From the Research
Causes of Viral Exanthem in Pediatric Patients
The causes of viral exanthem in pediatric patients can be attributed to various factors, including:
- Viral infections, such as Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6), and cytomegalovirus (CMV) 2, 3
- Bacterial toxins, drugs, allergens, and other diseases 2
- Interaction between viruses and drugs, which can lead to skin eruptions 2, 4, 5
- Concomitant viral infection and drug intake, making it challenging to differentiate between virus-induced and drug-induced skin eruption 2, 4
Viral Infections
Viral infections are a common cause of skin rashes in children, and can be caused by various viruses, including:
- Epstein-Barr virus (EBV) 2, 5
- Human herpesvirus 6 (HHV6) 2, 5
- Cytomegalovirus (CMV) 2
- Influenza virus 3, 6
- Rhinovirus 3
- Varicella zoster virus 3
- Herpes simplex virus 3
Drug-Virus Interplay
The interplay between viruses and drugs can lead to skin eruptions in children, and can be attributed to various mechanisms, including:
- Hapten/pro-hapten mechanism 5
- Pharmacological interaction (p-i mechanism) 5
- Altered repertoire model 5
- Human Leukocyte Antigen (HLA) predisposition 5
Diagnosis and Management
Diagnosing and managing viral exanthem in pediatric patients can be challenging, and requires a careful clinical history and thorough physical examination 2. Various tests, including serological and polymerase chain reaction (PCR) assays, can be helpful in diagnosing viral infections 2. Antiviral treatment and vaccination can be effective in preventing and treating viral infections 3, 6.