• Roseola

    (Exanthem Subitum; Roseola Infantum)

    Definition

    Roseola is an infection caused by a virus. It is characterized by a sudden onset of high fever followed by a rash. This disorder usually resolves on its own with no complications. Roseola can occur year round, but it is most common in the spring and fall.
    Roseola
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    Causes

    Roseola is usually caused by a virus called human herpesvirus 6 (HHV-6). It can also be caused by human herpesvirus 7 (HHV-7). These viruses are not the same as the herpes viruses that cause cold sores or genital herpes .

    Risk Factors

    Factors that increase the chance of roseola include:
    • Age: 6 months to 3 years; most common between 6 months and 15 months
    • Contact with an infected child is rarely reported

    Symptoms

    Symptoms of roseola include the following:
      Fever
      • 103°F to 105°F
      • Begins suddenly and is not associated with other symptoms
      • Lasts 3 days, occasionally a day or two longer
    • Convulsions may occur in association with high fever in up to 5% to 10% of children
    • Rash is characteristic in roseola and develops typically 12-24 hours after the fever
      • Appears first on chest and abdomen
      • Rose-colored
      • May spread to arms, legs, neck, and face
      • Lasts for a few hours to a few days and does not itch
      Other symptoms or signs may include:
      • Swelling of lymph nodes in the neck and behind the ears
      • Irritability
      • Poor appetite
      • Upper respiratory tract infection symptoms may be present before onset of fever
    The appearance of a rash after the fever disappears is the characteristic sign of roseola.

    Diagnosis

    The doctor will ask about symptoms and medical history. A physical exam will be done. The symptoms and physical findings of roseola are so distinctive that no other tests are usually needed. Often, there is a history of other children with roseola in the community.

    Treatment

    No treatment is needed for roseola unless the child is immunocompromised. The most important treatment is to keep the fever down and maintain good hydration with fluids.
    Discuss with your doctor how best to bring the fever down including:
    • Medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
    • Lukewarm sponge baths
    • Plenty of fluids
    • Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.
    Call your doctor if your child has a seizure and/or the fever persists.

    Prevention

    To help prevent the spread of roseola, avoid contact with an infected child when possible. The incubation period is 5-15 days. The virus is thought to be spread by contact with infected saliva, with adults forming the main reservoir. Carefully and frequently wash your hands to help prevent the spread of roseola.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    American Academy of Pediatrics http://www.aap.org/

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca/

    Alberta Health and Wellness http://www.health.gov.ab.ca/

    References

    Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ .

    Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

    The Merck Manual of Diagnosis and Therapy . 17th ed. Simon and Shuster; 1999.

    The National Library of Medicine website. Available at: http://www.nlm.nih.gov/ .

    The Nemours Foundation website. Available at: http://www.nemours.org/index.html .

    Revision Information

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