Roseola

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(Redirected from Exanthema subitum)

Roseola
exanthema subitum, roseola infantum, rose rash of
infants, sixth disease, baby measles, three-day fever

Roseola on a 21-month-old girl

Classification and external resources

Specialty

Infectious disease

ICD-10

B08.2

ICD-9-CM

057.8

DiseasesDB

5857

MedlinePlus

000968

eMedicine

emerg/400 derm/378 ped/998

MeSH

D005077

[edit on Wikidata]

Roseola is a disease of children, generally under two years old. [1] Although it has been known to
occur in eighteen-year-olds, whose manifestations are usually limited to a transient rash
("exanthem") that occurs following a fever of about three days' duration.
It is caused by two human herpesviruses, human herpesvirus 6 (HHV-6) and human herpesvirus
7 (HHV-7), which are sometimes referred to collectively as Roseolovirus. There are two variants of
HHV-6 (HHV-6a and HHV-6b) and studies in the US, Europe, Dubai and Japan have shown that
exanthema subitum is caused by HHV-6b. This form of HHV-6 infects over 90% of infants by age 2.
Research has shown that babies can be congenitally infected with HHV-6 via vertical transmission.[2]
Roseola occur in 1% of children in the United States.[3][4]
Contents
[hide]

1Signs and symptoms

2Cause

3Prevention

4Treatment

5Names

6References

7External links

Signs and symptoms[edit]

Typically the disease affects a child between six months and two years of age, and begins with a
sudden high fever (3940 C; 102.2-104 F). This can cause, in rare cases, febrile convulsions (also
known as febrile seizures or "fever fits") due to the sudden rise in body temperature, but in many
cases the child appears normal. After a few days the fever subsides, and just as the child appears to
be recovering, a red rash appears. This usually begins on the trunk, spreading to the legs and neck.
The rash is not itchy and may last 1 to 2 days.[5] In contrast, a child suffering from measles would
usually appear more infirm, with symptoms ofconjunctivitis, coryza, and a cough, and their rash
would affect the face and last for several days. Liver dysfunction can occur in rare cases.
A small percentage of children acquire HHV-6 with few sign or symptoms of the disease. Exanthema
subitum occurs in approximately 30% of children during primary HHV-6 infection. [6] Others may show
symptoms significant enough that other more serious infections, such as meningitis or measles
should be ruled out. In case of febrile seizures, medical advice can be sought for reassurance.
However, febrile seizures are not harmful, do not require treatment, and have no long term negative
effects unless they last longer than five minutes.
In rare cases, HHV-6 can become active in an adult previously infected during childhood and can
show signs of mononucleosis.[7]

Cause[edit]

Electron micrograph of HHV-6

It is caused by two human herpesviruses, human herpesvirus 6 (HHV-6) and human herpesvirus
7 (HHV-7), which are sometimes referred to collectively as Roseolovirus. There are two variants of
HHV-6 (HHV-6a and HHV-6b) and studies in the US, Europe, Dubai and Japan have shown that
exanthema subitum is caused by HHV-6b. This form of HHV-6 infects over 90% of infants by age 2.
Research has shown that babies can be congenitally infected with HHV-6 via vertical transmission.[2]

Prevention[edit]
There is no specific vaccine against or treatment for exanthema subitum, and most children with the
disease are not seriously ill. A child with fever should be given plenty of fluids to
drink. Paracetamol/acetaminophen or ibuprofen could be given to reduce their
temperature.Aspirin should not be used due to the risk of Reye's syndrome.[8]

Treatment[edit]
For HHV-6 infection, no pharmacological treatments have been approved as of June 2012. Although
they may be unnecessary for exanthema subitum, the use of Cytomegalovirus treatments
(valganciclovir, ganciclovir,[9] cidofovir, and foscarnet) have shown some success.[3] These drugs are

given with the intent of inhibiting proper DNA polymerization by competing with deoxy triphosphate
nucleotides[9] or specifically inactivating viral DNA polymerases.[10]

Roseola
Roseola is a viral infection that commonly affects infants and young children. It involves
a pinkish-red skin rash and high fever.

Causes
Roseola is common in children ages 3 months to 4 years, and most common in those
ages 6 months to 1 year.
It is caused by a virus called human herpesvirus 6 (HHV-6), although similar syndromes
are possible with other viruses.

Symptoms
The time between becoming infected and the beginning of symptoms (incubation
period) is 5 to 15 days.
The first symptoms include:

Eye redness

Irritability

Runny nose

Sore throat

High fever, that comes on quickly and may be as high as 105 F (40.5 C) and
can last 3 to 7 days
About 2 to 4 days after becoming sick, the child's fever lowers and a rash appears. This
rash most often:

Starts on the middle of the body and spreads to the arms, legs, neck, and face

Is pink or rose-colored

Has small sores that are slightly raised

The rash lasts from a few hours to 2 to 3 days. It usually does not itch.

Exams and Tests

Your health care provider will perform a physical exam and ask questions about the
child's medical history. The child may have swollen lymph nodes in the neck or back of
the scalp.

Treatment
There is no specific treatment for roseola. The disease most often gets better on its own
without complications.
Acetaminophen (Tylenol) and cool sponge baths can help reduce the fever. Some
children may have seizures when they get a high fever. If this occurs, call your health
care provider or go to the closest emergency room.

Possible Complications
Complications may include:

Aseptic meningitis (rare)

Encephalitis (rare)
Febrile seizure

When to Contact a Medical Professional

Call your health care provider if your child:

Has a fever that does not go down with the use of acetaminophen (Tylenol) or
ibuprofen (Advil) and a cool bath

Continues to appear very sick

Is irritable or seems extremely tired

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

Prevention
Careful handwashing can help prevent the spread of the viruses that cause roseola.

Alternative Names
Exanthem subitum; Sixth disease

What causes roseola?

Roseola is caused by two common viruses. The viruses belong to the family of herpes viruses,
but they do not cause the cold sores or genital infections that herpes simplexviruses can cause.
They are spread through tiny droplets of fluid from the nose and throat of infected people when
they laugh, talk, sneeze, orcough. Roseola mostly spreads from infected people who don't show
symptoms.
If your child has roseola, keep him or her at home until there has been no fever for 24 hours and
he or she is feeling better.

What are the symptoms?

Roseola often starts with a sudden high fever [103F (39.4C) to 105F (40.6C)] that lasts 2 to 3
days, although it can last up to 8 days. The rapid increase in temperature may be the first sign of
roseola and often occurs before you realize that your child has a fever. The fever ends suddenly.
After the fever ends, a rosy-pink rash may appear mostly on the trunk (torso), neck, and arms.
The rash is not itchy and may last 1 to 2 days.
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In rare cases, a sore throat, stomach ache, vomiting, and diarrhea occur.

A child with roseola may appear fussy or irritable and may have a decreased appetite, but most
children behave almost normally.

How is roseola diagnosed?

Roseola is diagnosed through a medical history and physical exam. The doctor often knows it's
roseola if your child had a fever and now has a distinct rash.

How is it treated?
The roseola fever can be managed with acetaminophen (such as Tylenol),ibuprofen (such
as Advil or Motrin), or sponge baths. If you give medicine to your baby, follow your doctor's
advice about what amount to give. Do not give aspirin to anyone younger than 20 years of age
because of the risk of Reye syndrome.
The roseola rash will go away without medical treatment.

Should you worry if your child has roseola?

Roseola generally is a harmlessviral infection. Like any illness
that can cause a fever, it can cause fever seizures, which are
uncontrolled muscle spasms and unresponsiveness that last 1
to 3 minutes. The fever seizure is caused by the rapid increase
in temperature in a short period of time. After a fever has
reached a high temperature, the risk of a seizure is probably
over.
Contact the doctor if:
Your child's rash gets worse.
Symptoms (such as a fever, a general feeling of illness, or
signs of infection) are severe or become worse.
Symptoms become so uncomfortable that your child
cannot tolerate them.
A new rash continues longer than 1 week.

 A rash that has been previously diagnosed continues

longer than 4 weeks or is not following the expected
course.
Your child's symptoms become more severe or more
frequent.

My child has a spotty, pinkish-red rash on his

stomach. Could it be roseola?

If your child recently had a fever and now has a spotty, raised or flat, rosy-pink rash,
it could be roseola, also called roseola infantum or sixth disease.

Scott Camazine / Science Source

Roseola is a fairly mild and common viral illness that usually strikes children between
6 months and 3 years of age. It's caused by a kind of herpes virus, although not the
type that's sexually transmitted.

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.

Slideshow

When your child has roseola

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.

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.
advertisement

Roseola

In this article

My child has a spotty, pinkish-red rash on his stomach. Could it be roseola?

What are the symptoms of roseola?

Should I call the doctor?

What's the treatment for roseola?

Is roseola contagious?
En espaol
Reviewed by the BabyCenter Medical Advisory Board

My child has a spotty, pinkish-red rash on his stomach. Could it be roseola?

If your child recently had a fever and now has a spotty, raised or flat, rosy-pink rash, it could
be roseola, also called roseola infantum or sixth disease.

 Scott Camazine / Science Source

Roseola is a fairly mild and common viral illness that usually strikes children between 6
months and 3 years of age. It's caused by a kind of herpes virus, although not the type
that's sexually transmitted.
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.

Slideshow
When your child has roseola

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.
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.
advertisement

Roseola
Reviewed by the BabyCenter Medical Advisory Board

What's the treatment for roseola?

There's no specific treatment for roseola. Like most viral illnesses, it just needs to run its
course. The most important thing you can do is make sure your child rests and gets plenty
of liquids to avoid dehydration.
Depending on how uncomfortable your child is, the doctor may suggest giving him
children's acetaminophen (or ibuprofen, for kids at least 6 months old) to bring down the
fever.

You can also try to reduce your child's fever by sponging him down with lukewarm (not cold)
water or giving him a lukewarm bath.
Never give a child aspirin. It can trigger Reye's syndrome, a rare but potentially fatal
disorder.

Is roseola contagious?
Yes, and it spreads especially easily among young children.
Roseola spreads through saliva or respiratory droplets when an infected child sneezes or
coughs, for example. It also spreads by fecal-oral contact when an infected child doesn't
wash his hands after going to the bathroom, for example. Because a child is contagious
before he has symptoms, there's often no way to avoid exposure.
Make sure that all family members, especially those who take care of your child, wash their
hands frequently. (This is a good idea even in the fever stage, because you don't know that
you're dealing with roseola until you see the classic rash.)
To play it safe, keep kids home from daycare and school and away from others when they
have a fever. If the roseola rash appears, it's probably wise to keep them home until the
rash is gone, although they're less contagious once they have the rash than when they had
the fever.
The good news: Once your child has had roseola, he'll probably have lifelong immunity to it.
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