Gianotti-Crosti syndrome associated with infections other than hepatitis B
Z. K. Draelos, R. C. Hansen and W. D. James
Although the Gianotti-Crosti syndrome (GCS) is regularly associated with
hepatitis B infection elsewhere, in North America that association is
rarely made. Accordingly, we studied nine children with acral, symmetrical
eruptions typical of GCS for evidence of other infections. All were
negative for hepatitis B surface antigen. Viral cultures were done in nine
patients, and viruses isolated in two. One patient with a respiratory
prodrome had respiratory syncytial virus (RSV) isolated, and a second
patient studied simultaneously showed serological evidence of RSV
infection. A third patient with both respiratory tract and gastrointestinal
tract symptoms yielded a polio-vaccine enterovirus. Two patients with fever
and pharyngitis had group A beta-hemolytic streptococci isolated from the
throat. Skin biopsies were done in three cases, and findings were
consistent with GCS. Electron microscopy of two lesional biopsy specimens
failed to demonstrate viral particles. Epstein-Barr virus serological
findings were negative in six cases and showed evidence of past infection
in three cases. This study strengthens the observation that hepatitis B is
not the causative agent of GCS in this country and suggests that multiple
infectious agents may be associated with this distinctive exanthem.
