ICD-10: B08.22

Exanthema subitum, commonly known as sixth disease or roseola, is primarily caused by human herpesvirus 6 (HHV-6) and, less frequently, by human herpesvirus 7 (HHV-7). The ICD-10 code B08.22 specifically refers to cases of exanthema subitum that are attributed to HHV-7. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Exanthema Subitum

Etiology

Exanthema subitum is a viral infection predominantly affecting infants and young children, typically between the ages of 6 months and 2 years. While HHV-6 is the most common causative agent, HHV-7 can also lead to similar clinical manifestations. Both viruses belong to the Herpesviridae family and are known for their ability to establish latent infections in the host.

Symptoms

The clinical presentation of exanthema subitum generally includes:

• Fever: The illness often begins with a sudden high fever, which can reach up to 39.4°C (103°F) and may last for 3 to 5 days. This fever is usually the first symptom and can be accompanied by irritability and mild respiratory symptoms.
• Rash: After the fever subsides, a characteristic rash appears. The rash typically starts on the trunk and then spreads to the face and extremities. It consists of small, pink, or red spots that may merge to form larger patches. The rash is not itchy and usually resolves within a few days.
• Other Symptoms: Some children may experience mild diarrhea, lymphadenopathy, or conjunctivitis, although these are less common.

Diagnosis

Diagnosis of exanthema subitum due to HHV-7 is primarily clinical, based on the characteristic fever followed by a rash. Laboratory confirmation can be achieved through serological tests or PCR to detect HHV-7 DNA, although this is not routinely performed in typical cases.

Complications

Exanthema subitum is generally a benign condition with a good prognosis. However, complications can occur, particularly in immunocompromised individuals. Potential complications include febrile seizures due to high fever, and in rare cases, encephalitis or other neurological manifestations.

ICD-10 Code B08.22

The ICD-10 code B08.22 specifically denotes exanthema subitum due to human herpesvirus 7. This classification is important for accurate medical coding and billing, as well as for epidemiological tracking of the disease. The code falls under the broader category of viral exanthems, which includes various other viral infections characterized by rashes.

Related Codes

• B08.2: Exanthema subitum (general code for sixth disease).
• B08.21: Exanthema subitum due to human herpesvirus 6.

Conclusion

Exanthema subitum, particularly when caused by HHV-7, is a common viral infection in young children characterized by a sudden onset of fever followed by a distinctive rash. While it is typically self-limiting, understanding the clinical features and proper coding with ICD-10 code B08.22 is essential for healthcare providers in managing and documenting this condition effectively. If further information or clarification is needed regarding specific cases or management strategies, consulting a pediatric infectious disease specialist may be beneficial.

Exanthema subitum, commonly known as sixth disease or roseola, is primarily caused by human herpesvirus 6 (HHV-6) and, less frequently, by human herpesvirus 7 (HHV-7). The ICD-10 code B08.22 specifically refers to cases of exanthema subitum due to HHV-7. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is essential for accurate diagnosis and management.

Clinical Presentation

Age Group

Exanthema subitum predominantly affects infants and young children, typically between the ages of 6 months and 2 years. The disease is less common in older children and adults, as most individuals have been exposed to the virus by early childhood, leading to immunity[11][14].

Initial Symptoms

The clinical course of exanthema subitum usually begins with a sudden onset of high fever, often exceeding 39.4°C (103°F). This fever can last for 3 to 5 days and is often accompanied by mild respiratory symptoms, such as a runny nose or cough. The fever is typically the most prominent symptom during the initial phase of the illness[11][13].

Rash Development

After the fever subsides, a characteristic rash appears. This rash is usually maculopapular and can be described as rose-colored spots that may start on the trunk and then spread to the face, neck, and extremities. The rash is not itchy and generally resolves within a few days[11][14].

Signs and Symptoms

Fever

• High Fever: Sudden onset, often high-grade, lasting 3-5 days.
• Febrile Seizures: In some cases, the high fever may lead to febrile seizures, particularly in children with a history of such events[11][14].

Rash

• Maculopapular Rash: Appears after the fever resolves, typically starting on the trunk and spreading outward.
• Non-Pruritic: The rash is generally not itchy, which helps differentiate it from other viral exanthems[11][13].

Other Symptoms

• Mild Respiratory Symptoms: Such as nasal congestion or cough may accompany the fever.
• Lymphadenopathy: Swelling of lymph nodes may be observed, particularly in the neck region[11][14].

Patient Characteristics

Demographics

• Age: Most commonly seen in infants and toddlers aged 6 months to 2 years.
• Immunocompetence: Typically occurs in otherwise healthy children; however, immunocompromised individuals may experience more severe manifestations[11][14].

Risk Factors

• Exposure to Infected Individuals: Close contact with other children or adults who may be shedding the virus can increase the risk of infection.
• Seasonality: While exanthema subitum can occur year-round, it may be more prevalent in certain seasons, similar to other viral infections[11][14].

Conclusion

Exanthema subitum due to human herpesvirus 7 (ICD-10 code B08.22) is characterized by a distinct clinical presentation that includes a sudden high fever followed by a non-itchy maculopapular rash. Understanding the typical signs and symptoms, along with the patient demographics, is crucial for healthcare providers in diagnosing and managing this common childhood illness. Early recognition can help alleviate parental anxiety and ensure appropriate care, especially in cases where febrile seizures may occur.

Exanthema subitum, commonly known as sixth disease, is primarily associated with human herpesvirus 6 (HHV-6) but can also be caused by human herpesvirus 7 (HHV-7). The ICD-10 code B08.22 specifically refers to cases of Exanthema subitum due to HHV-7. Here are some alternative names and related terms for this condition:

Alternative Names

1. Roseola Infantum: This term is often used interchangeably with Exanthema subitum, although it typically refers to the condition caused by HHV-6.
2. Sixth Disease: This is the most common name for Exanthema subitum, indicating its position as the sixth classical childhood exanthema.
3. Exanthema Subitum: The medical term for the condition, which translates to "sudden rash" in Latin.
4. Human Herpesvirus 7 Infection: This term emphasizes the viral cause of the condition when specifically linked to HHV-7.

Related Terms

1. Viral Exanthema: A broader term that encompasses rashes caused by viral infections, including Exanthema subitum.
2. Febrile Rash: This term describes the fever that often precedes the rash in cases of Exanthema subitum.
3. Herpesvirus Infections: A general category that includes infections caused by various herpesviruses, including HHV-6 and HHV-7.
4. Childhood Exanthems: A category of diseases characterized by rashes in children, which includes conditions like measles, rubella, and roseola.

Clinical Context

Exanthema subitum is characterized by a sudden high fever followed by a distinctive rash, typically affecting infants and young children. The rash usually appears after the fever subsides, which can lead to confusion with other viral exanthems. Understanding the terminology and related terms is crucial for accurate diagnosis and treatment.

In summary, while B08.22 specifically refers to Exanthema subitum due to HHV-7, the condition is often discussed in the context of broader terms and alternative names that reflect its clinical presentation and viral etiology.

Exanthema subitum, commonly known as sixth disease, is primarily caused by human herpesvirus 6 (HHV-6) and, in some cases, human herpesvirus 7 (HHV-7). The ICD-10-CM code B08.22 specifically refers to exanthema subitum due to HHV-7. The diagnosis of this condition involves several clinical criteria and considerations.

Clinical Presentation

Symptoms

The diagnosis of exanthema subitum typically includes the following symptoms:

• Fever: A sudden high fever, often exceeding 39°C (102°F), is usually the first symptom and can last for 3 to 5 days.
• Rash: After the fever subsides, a characteristic rash appears, which is usually rose-colored and may start on the trunk before spreading to the face and extremities. The rash is often not itchy and can last for several days.
• Irritability: Children may exhibit irritability and discomfort during the febrile phase.
• Lymphadenopathy: Mild swelling of lymph nodes may be observed.

Age Group

Exanthema subitum predominantly affects infants and young children, typically between 6 months and 2 years of age, making age a critical factor in diagnosis.

Diagnostic Criteria

Laboratory Testing

While the diagnosis is primarily clinical, laboratory tests can support the diagnosis:

• Serological Tests: Detection of specific IgM antibodies against HHV-7 can confirm recent infection. However, IgM testing is less commonly performed than for HHV-6.
• Polymerase Chain Reaction (PCR): PCR testing can be used to detect HHV-7 DNA in blood or other specimens, providing a more definitive diagnosis.

Differential Diagnosis

It is essential to differentiate exanthema subitum from other conditions that present with similar symptoms, such as:

• Roseola infantum: Often confused with exanthema subitum, but typically caused by HHV-6.
• Other viral exanthems: Such as measles, rubella, or varicella, which may present with fever and rash.

Conclusion

In summary, the diagnosis of exanthema subitum due to human herpesvirus 7 (ICD-10 code B08.22) is primarily based on clinical presentation, particularly the sequence of fever followed by a rash in young children. Laboratory tests can aid in confirming the diagnosis, especially in atypical cases or when differentiating from other viral infections. Understanding these criteria is crucial for accurate diagnosis and management of the condition.

Exanthema subitum, commonly known as sixth disease, is primarily caused by human herpesvirus 6 (HHV-6) and, less frequently, by human herpesvirus 7 (HHV-7). The ICD-10 code B08.22 specifically refers to exanthema subitum due to HHV-7. This viral infection is most prevalent in infants and young children, typically presenting with a sudden high fever followed by a characteristic rash.

Clinical Presentation

Symptoms

• Fever: The illness often begins with a high fever (up to 39.5°C or 103°F) that lasts for 3 to 5 days.
• Rash: After the fever subsides, a rash appears, usually starting on the trunk and then spreading to the face and extremities. The rash is typically rose-colored and may be maculopapular.
• Other Symptoms: Mild respiratory symptoms, irritability, and lymphadenopathy may also be present.

Diagnosis

Diagnosis of exanthema subitum is primarily clinical, based on the characteristic fever and rash pattern. Laboratory tests are not routinely required but may include:
- Serology: Detection of specific antibodies to HHV-6 or HHV-7.
- Polymerase Chain Reaction (PCR): This can be used to identify viral DNA in blood or other samples, although it is not commonly performed in routine cases.

Treatment Approaches

Supportive Care

The standard treatment for exanthema subitum, particularly when caused by HHV-7, is supportive care, as the condition is generally self-limiting. Key components include:

• Fever Management: Antipyretics such as acetaminophen or ibuprofen can be administered to reduce fever and improve comfort.
• Hydration: Ensuring adequate fluid intake is crucial, especially if the child is experiencing fever and irritability.
• Rest: Encouraging rest helps the body recover from the viral infection.

Monitoring

• Observation: Parents and caregivers should monitor the child for any complications, such as febrile seizures, which can occur due to high fever.
• Follow-Up: If symptoms worsen or do not improve, a follow-up with a healthcare provider is recommended to rule out other conditions.

Complications

While exanthema subitum is usually benign, potential complications can include:
- Febrile Seizures: These can occur in some children due to high fever.
- Secondary Infections: As with any viral illness, there is a risk of secondary bacterial infections.

Conclusion

Exanthema subitum due to human herpesvirus 7 (ICD-10 code B08.22) is typically managed with supportive care, focusing on fever reduction and hydration. The condition is self-limiting, and most children recover without complications. Parents should be educated about the signs of complications and the importance of follow-up care if symptoms persist or worsen.