Roseola infantum (ro-see-O-luh in-FAN-tum) is a viral infection seen in young children that produces a rash and high fever.
Also known as exanthem subitum (ek-ZAN-thum SU-bih-tum), roseola infantum is an acute * viral infection that mainly affects children between the ages of six months and three years and is characterized by high fever followed by a rash. The disease stems from infection with human herpesvirus (her-peez-VY-rus) type 6 (HHV 6) or human herpesvirus type 7 (HHV 7). Both of these belong to the same family of viruses as varicella zoster (var-uh-SEH-luh ZOS-ter), which causes chickenpox; EpsteinBarr (EP-steen BAR) virus, which causes mononucleosis * ; cytomegalovirus * ; and herpes simplex * virus.
HHV6 and HHV7 affect almost all children who are between six months and three years of age, but not all of these infections produce the illness recognized as roseola infantum. Roseola rarely is seen in children over four years of age, and the illness appears most often during the spring and fall.
Roseola spreads from person to person, most likely through tiny drops of fluid expelled from the mouth and nose of an infected child when he or she laughs, coughs, sneezes, or talks.
Symptoms of roseola infantum usually appear between 5 and 15 days after exposure to the virus. Children may first have a mild respiratorytract * illness, followed by a high fever that can reach 105 degrees Fahrenheit and last from two to five days. When the fever subsides, a rash appears, starting on the trunk of the body and spreading to the limbs, face, and neck. The rash of raised red and pink splotches, which fade to white when pressed, lasts from one to three days. Additional symptoms of the infection can include tiredness, swollen eyelids, a runny nose, swollen lymph nodes * in the neck, and irritability. In up to 10 percent of children, the high fever associated with roseola infantum causes febrile seizures * .
To diagnose roseola, doctors look for physical symptoms and signs such as rash and swollen lymph nodes, particularly those in the back of the scalp. A medical history may show that the child has been exposed to others with the disease at home or in a childcare setting. Because the rash appears after the fever, roseola often is diagnosed after the child has begun to recover from the illness.
Most cases of roseola infantum respond well to treatment at home. Acetaminophen * can help lower a fever, and drinking lots of clear fluids can prevent dehydration * . Children usually feel ill only while they still have a fever and probably will be less active during that time. By the time the rash appears, a child's behavior may be almost back to normal.
Most cases of infection resolve in four to six days without additional problems. Seizures are the most common complication, but this does not mean that the child will have an increased risk of a long-term seizure problem. In rare cases, the disease may lead to the development of meningitis (meh-nin-JY-tis, an inflammation of the membranes covering the brain and spinal cord) or encephalitis (en-seh-fuh-LYE-tis, an inflammation of the brain).
There is no simple way for children to avoid exposure to HHV6 and HHV7 completely. Young children have lots of close contact with each other. Adults rarely contract this illness, possibly indicating that having roseola as a child provides lifelong immunity * to the viruses. Some children do experience a second bout of the disease, but this occurs infrequently. Like other viruses in this family, HHV6 and HHV7 can reactivate after the first infection and cause illness, which happens primarily in people who have a weakened immune system.
See also Chickenpox (Varicella) • Cytomegalovirus (CMV) Infection • Encephalitis • Herpes Simplex Virus Infections • Meningitis • Mononucleosis, Infectious • Shingles (Herpes Zoster) • Viral Infections
O'Grady, Jason S. “Fifth and Sixth Diseases: More Than a Fever and a Rash.” The Journal of Family Practice. October 2014. http://www.jfponline.com/fileadmin/qhi/jfp/pdfs/6310/JFP_06310_Article1W.pdf (accessed August 12, 2015).
MedlinePlus. “Roseola.” U.S. National Library of Medicine. http://www.nlm.nih.gov/medlineplus/ency/article/000968.htm (accessed August 12, 2015).
NHS Choices. “Roseola.” National Health Services. http://www.nhs.uk/conditions/roseola/pages/introduction.aspx (accessed November 16, 2015).
Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 800-232-4636. Website: http://www.cdc.gov (accessed August 12, 2015).
The Society for Pediatric Dermatology. 8635 Keystone Crossing, Suite 107, Indianapolis, IN 46240. Telephone: 317-202-0224. Website: http://pedsderm.net (accessed August 12, 2015).
* acute describes an infection or other illness that comes on suddenly and usually does not last very long.
* mononucleosis (mah-no-nuklee-O-sis) is an infectious illness caused by a virus with symptoms that typically include fever, sore throat, swollen glands, and tiredness.
* cytomegalovirus (sy-tuh-MEHguh-lo-vy-rus), or CMV, infection is common and usually causes no symptoms. It poses little risk for healthy people, but it can lead to serious illness in people with weak immune systems.
* herpes simplex (HER-peez SIMplex) is a virus that can cause infections of the skin, mouth, genitals, and other parts of the body.
* respiratory tract, also called the respiratory system, includes the nose, mouth, throat, and lungs. It is the pathway through which air and gases are transported down into the lungs and back out of the body.
* lymph nodes (LIMF) are small, bean-shaped masses of tissue containing immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.
* seizures (SEE-zhurs), also called convulsions, are sudden bursts of disorganized electrical activity that interrupt the normal functioning of the brain, often leading to uncontrolled movements in the body and sometimes a temporary change in consciousness.
* acetaminophen (uh-see-tehMIH-noh-fen) is a medication commonly used to reduce fever and relieve pain.
* dehydration (dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unreplaced loss of body fluids, such as through sweating, vomiting, or diarrhea.
* immunity (ih-MYOON-uh-tee) is the condition of being protected against an infectious disease. Immunity often develops after a germ has entered the body. One type of immunity occurs when the body makes special protein molecules called antibodies to fight the disease-causing germ. The next time that germ enters the body, the antibodies quickly attack it, usually preventing the germ from causing disease.