Roseola

Answer 1

Definition

Roseola is an acute disease of infants and young children in which a high fever and skin rash occur.

Alternative Names

Exanthem subitum; Sixth disease

Causes, incidence, and risk factors

The disease is common in children ages 3 months to 4 years, and most common in those ages 6 months to 1 year. It is caused by a virus called human herpesvirus 6 (HHV-6), although similar syndromes are possible with other viruses.

Roseola occurs throughout the year. The time between becoming infected and the beginning of symptoms (incubation period) is 5 to 15 days.

Symptoms

The child may have a runny nose, sore throat, and eye redness.

A fever usually occurs before the rash appears. It lasts for 3 (sometimes up to 7) days. The fever may be as high as 105 Fahrenheit, and it generally responds well to acetaminophen (Tylenol).

Between the second and fourth day of the illness, the fever drops and a rash appears (often as the fever falls).

• The rash starts on the trunk and spreads to the limbs, neck, and face. The rash is pink or rose-colored, and has fairly small sores that are slightly raised.
• The rash lasts from a few hours to 2-3 days. It usually does not itch.

Other symptoms include:

• Irritability
• High fever that comes on quickly

Signs and tests

• Physical exam of rash
• Swollen lymph nodes on the neck (cervical nodes) or back of the scalp (occipital nodes)

Treatment

There is no specific treatment. The disease usually gets better without complications.

Take steps to control a fever with acetaminophen (Tylenol) and cool sponge baths. If convulsions occur, call your health care provider, or go to the closest emergency room.

Expectations (prognosis)

Most children with roseola fully recover.

Complications

• Aseptic meningitis (rare)
• Encephalitis(rare)
• Febrile seizure

Calling your health care provider

Call your health care provider if your child:

• Has a fever that does not go down with acetaminophen (Tylenol) or ibuprofen (Advil) and a warm bath
• Continues to appear very sick
• Acts irritable or lethargic

Go to the emergency room or call the local emergency number (such as 911) if your child has convulsions.

Prevention

The viruses that cause roseola are spread either through fecal-oral contact or via airborne droplets. Careful handwashing can help prevent the spread of these viruses.

References

Leach CT. Roseola (Human Herpesviruses 6 and 7). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 253.

Answer 2

Definition

Roseola is a viral infection that commonly affects infants and young children. It involves a pinkish-red skin rash and high fever.

Alternative Names

Exanthem subitum; Sixth disease

Causes, incidence, and risk factors

Roseola is common in children ages 3 months to 4 years, and most common in those ages 6 months to 1 year.

It is caused by a virus called human herpesvirus 6 (HHV-6), although similar syndromes are possible with other viruses.

Symptoms

The time between becoming infected and the beginning of symptoms (incubation period) is 5 to 15 days.

The first symptoms include:

• Eye redness
• Irritability
• Runny nose
• Sore throat
• High fever, that comes on quickly and may be as high as 105° Fahrenheit and can last 3 to 7 days

About 2 - 4 days after becoming sick, the child's fever lowers and a rash appears. This rash usually:

• Starts on the middle of the body and spreads to the arms, legs, neck, and face.
• Pink or rose-colored,
• Has small sores that are slightly raised

The rash lasts from a few hours to 2 - 3 days. It usually does not itch.

Signs and tests

Your health care provider will perform a physical exam and ask questions about the child's medical history. The child may have swollen lymph nodes in the neck or back of the scalp.

Treatment

There is no specific treatment for roseola. The disease usually gets better on its own without complications.

Acetaminophen (Tylenol) and cool sponge baths can help reduce the fever. Some children may have seizures when they get high fevers. If this occurs, call your doctor or go to the closest emergency room.

Complications

• Aseptic meningitis (rare)
• Encephalitis(rare)
• Febrile seizure

Calling your health care provider

Call your health care provider if your child:

• Has a fever that does not go down with acetaminophen (Tylenol) or ibuprofen (Advil) and a cool bath
• Continues to appear very sick
• Is irritable or seems extremely tired

Go to the emergency room or call the local emergency number (such as 911) if your child has convulsions.

Prevention

Careful handwashing can help prevent the spread of the viruses that cause roseola.

References

Leach CT. Roseola (human herpesviruses 6 and 7). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 253.

Caserta MT. Roseola. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 248.

Reviewed By

Review Date: 08/02/2011

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.