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Roseola

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

Alternative Names

Exanthem subitum; Sixth disease

Causes, incidence, and risk factors

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° Fahrenheit and can last 3 to 7 days

About 2 - 4 days after becoming sick, the child's fever lowers and a rash appears. This rash usually:

  • Starts on the middle of the body and spreads to the arms, legs, neck, and face.
  • Pink or rose-colored,
  • Has small sores that are slightly raised

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

Signs 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 usually 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 high fevers. If this occurs, call your doctor or go to the closest emergency room.

Complications

Calling your health care provider

Call your health care provider if your child:

  • Has a fever that does not go down with 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.

References

Leach CT. Roseola (human herpesviruses 6 and 7). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 253.

Caserta MT. Roseola. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 248.

Updated: 8/2/2011

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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