The usefulness of confirming primary HHV-6 infection in febrile infants and toddlers in a hospital emergency department

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The study by Zerr et al confirms the relatively high incidence (18%) of primary HHV-6 infection in infants and toddlers brought to medical attention because of fever. They also confirm the high rates of nonbeneficial management and tests performed to seek diagnoses of serious bacterial infection in infants whose cause of fever is HHV-6; 34% with primary HHV-6 were hospitalized, 32% were given antibiotics empirically, 60% had bladder catheterization, 47% had radiograph performed, and 6% had lumbar puncture performed. The investigators tested the potential utility of PCR testing of plasma, aimed at avoiding this clinical pathway in those found to have HHV-6. They found that rapid diagnosis of HHV-6 virema may not differentiate infants with and without serious bacterial infection.