Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

728 Horner’s Syndrome Human Herpes 6

■Cause of syndrome may be central lesion or lesion of preganglionic

or postganglionic sympathetic neuron; associated clinical context &

findings & results of chest x-ray or CT scan will help to localize lesion

& distinguish brain stem or cervical cord lesion, thoracic or neck

tumor, cervical trauma, carotid artery lesion, intracranial disease

management

■Evaluate underlying cause

specific therapy

■Treat underlying cause

follow-up

■Depends on underlying cause

complications and prognosis

■Depend on underlying cause

Human Herpes 6.....................................

CAROL A. GLASER, MD

history & physical

History

■HHV6 member herpesvirus family (herpesvirus 6) (aka “sixth dis-

ease”)

■Humans only host

■Transmission; via respiratory secretions

■Incubation period: Around 9–10 days

■Attack rate highest 6–24 months

■Ubiquitous agent

■Lifelong persistent infection – intermittent asymptomatic shedding

■reactivation can occur

Signs & Symptoms

■“roseola” (exanthem subitum)

■high fever (>39.5)×3–7 days followed by erythematous maculopapu-

lar rash

■seizures can occur in primary infection encephalitis in immunocom-

petent pt

■cervical/posterior occipital lymphadenopathy

■gastrointestinal symptoms