Roseola

Definition

Roseola is an acute disease of infants and young children that is characterized by a high fever and skin rash.

Causes

The disease is common in children 3 months to 4 years old, and most common in those between 6 months and 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 incubation period (the time between becoming infected and the beginning of symptoms)  is 5 to 15 days. A fever lasting 3 (sometimes up to 7) days generally comes before the rash appears. The fever may be as high as 105 degrees Fahrenheit.

Roseola begins with a high fever that generally responds well to acetaminophen (Tylenol). Between the 2nd and 4th day of illness, the fever falls dramatically, and a rash appears (often as the fever falls) on the trunk and spreads to the limbs, neck, and face. The rash lasts from a few hours to 2 days.

Symptoms

• An abrupt onset of high fever
• Irritability
• A rash erupts on the 4th or 5th day of the illness (the fever has usually resolved or is dropping by the time the rash appears)

Exams and Tests

• A history of roseola in the community
• A physical exam of rash
• Swollen lymph nodes on the back of the scalp (occipital nodes)

Treatment

There is no specific treatment. The disease usually resolves without complications. Measures should be taken to control a fever. Acetaminophen and cool sponge baths may be given. If convulsions occur, call your health care provider, or go to the closest emergency room.

Outlook (Prognosis)

The vast majority of children with roseola fully recover.

Possible Complications

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

When to Contact a Medical Professional

Call your health care provider if your child's fever does not go down after the child has been given acetaminophen (Tylenol) or ibuprofen (Advil) and a warm bath, or if the child continues to appear very sick, or act irritable or lethargic.

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

Prevention

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