Roseola infantum (exanthem subitum, pseudorubella) is a viral infection of infants or very young children that causes a high fever followed by a rash.
Roseola infantum is caused by human herpesvirus 6.
Typical symptoms include high fever that begins suddenly and sometimes a rash that develops after the temperature returns to normal.
The diagnosis is based on symptoms and the age of the child.
Treatment aims to relieve symptoms.
Roseola infantum occurs throughout the year. Sometimes minor local outbreaks occur. The usual cause is herpesvirus 6, one of the many human herpesviruses.
Most children who develop roseola infantum are between 6 months and 3 years of age.
What are the symptoms of roseola?
It’s possible to have the virus without having noticeable symptoms. In fact, roseola usually starts with a sudden, relatively high fever, often over 103 degrees Fahrenheit.
The fever typically lasts three to five days and may end abruptly, followed by the telltale rash. The rash may last for days or only hours.
The rash is pink and may have small flat spots or raised bumps. These spots may have a lighter “halo” around them and will turn white if you press on them.
The rash isn’t itchy or uncomfortable, and contact with the rash itself doesn’t spread the illness. It usually shows up on the trunk and neck, but can extend to the arms, legs, and face.
If your child has roseola, he may be irritable and tired and have mild diarrhea, a poor appetite, red eyes, swollen eyelids, a runny nose, or a sore throat.
The lymph nodes in his neck and at the base of his skull may also be a bit enlarged. Most children with roseola don’t appear especially ill, considering how high their fever gets.
About 10 to 15 percent of children with roseola have a febrile seizure. If this happens, your child may become unconscious and jerk his arms, legs, or facial muscles for two or three minutes.
He may also lose control of his bladder or bowels.
Although frightening, fever-induced seizures in young children are seldom serious or harmful. If you can, try to time the length of the seizure. Your child’s doctor will want to know how long the episode lasted.
A doctor’s evaluation
A doctor suspects roseola infantum when typical symptoms (particularly development of a rash after a fever goes away) appear in a child aged 6 months to 3 years.
Tests are rarely done, but the diagnosis can be confirmed with blood tests.
Acetaminophen or ibuprofen for fever
Fever is treated with acetaminophen or ibuprofen. The seizures and rash do not require any specific treatment, but because they are frightening, most parents bring their child to the doctor for evaluation.
If the disease is severe in children with a weakened immune system, doctors may try treating them with the antiviral drugs foscarnet or ganciclovir.
Should I call the doctor?
Yes. It’s a good idea to check with the doctor if your child has a fever and a rash. The doctor will ask about your child’s symptoms and – depending on your child’s age and symptoms – may want to take a look at him.