Roseola Infantum

Also called exanthema subiturn, roseola infantum is an acute, benign, presumably viral infection. It usually affects infants and young children (ages 6 months to 3 years).

Roseola affects boys and girls alike. It occurs year-round but is most prevalent in the spring and fall. Overt roseola, the most common exanthem in infants under age 2, affects 30% of all children; inapparent roseola (febrile illness without a rash) may affect the rest.

Characteristically, it first causes a high fever and then a rash that accompanies an abrupt drop to normal temperature.

Causes

Roseola is caused by many viruses. The most common cause is the human herpesvirus 6 (HHV-6). It occurs mostly in children under the age of 3. Roseola is contagious, although the way it is spread is not known. It occurs mostly in the spring and fall.

Signs and symptoms

The signs and symptoms of roseola include:

The child develops a high temperature of up to 40ºC (possibly higher), which usually lasts for a few hours, but may last three to five days.
As the temperature falls, a raised, red rash appears - first on the body and neck, and later on the face, arms and legs.
The rash lasts from a few hours to one or two days.
Roseola may also cause a fever without the rash.
Children with roseola recover fully, usually within a week.

Diagnosis

Diagnosis requires observation of the typical rash that appears about 48 hours after fever subsides.

Treatment

Because roseola is self-limiting, treatment is supportive and symptomatic: antipyretics to lower fever and, if necessary, anticonvulsants to relieve seizures.

Prevention

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

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