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Roseola Infantum
Aka: Roseola Infantum, Roseola, Sixth Viral Exanthem of Childhood, Exanthem Subitum, Human Herpes Virus 6, HH6
- Etiology
- Human Herpes Virus Type 6
- Human Herpes Virus (Herpesviridae)
- Epidemiology
- Peak ages: 6-18 months
- Very common
- Prevalence of Antibody to HHV-6 approaches 100% by 3 years of age
- Signs
- Days 1-2
- Anorexia
- Vomiting
- Diarrhea (variable)
- Mild cough or Rhinorrhea (variable)
- Occipital Lymphadenopathy
- Days 2-3
- High Fever starts (103 to 106 F)
- Occurs at onset without accompanying localizing signs
- Fever Without Focus
- Often a diagnostic dilemma until the rash appears
- Child appears well without focal findings
- Mild cough or Rhinorrhea may be present
- Mild Diarrhea may be present
- Day 4
- Rash onset as fever abates
- Fine, erythematous or pink Macules and Papules (maculopapular rash)
- Pink, blanchable, almond shaped Macules
- Most common centrally on the trunk and neck (may spread peripherally to extremities)
- Macules become confluent with one another and then fade within hours to 2 days
- Other associated findings
- Viral Sialoadenitis (especially Parotid Gland)
- Differential Diagnosis
- See Fever Without Focus
- Rubeola (Measles)
- Rash in Measles starts on face (especially behind ears) and spreads inferiorly
- Children with Measles appear ill (contrast with normal appearance in Roseola)
- Complications
- Febrile Seizures (common cause)
- Management
- Symptomatic
- Tylenol or Ibuprofen for fever
- References
- Latessa (2012) AAFP Board Review Express, San Jose
- Allmon (2015) Am Fam Physician 92(3): 211-6 [PubMed]