(Exanthem Subitum; Roseola Infantum)
  • Definition

    Roseola is an infection caused by a virus. It is characterized by a sudden onset of high fever followed by a rash. The infection usually ends on its own without complications.
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  • Causes

    Roseola is usually caused by a virus called human herpesvirus 6 (HHV-6). It can also be caused by human herpesvirus 7 (HHV-7). These viruses are not the same as the herpes viruses that cause cold sores or genital herpes.
  • Risk Factors

    Factors that increase the chance of roseola include:
    • Age: 6 months to 3 years; most common between 6 months and 15 months
    • Contact with an infected child is rarely reported
    • Season: Most common in the Spring and Fall
  • Symptoms

    Symptoms of roseola include:
    • Fever
      • 103°F to 105°F
      • Begins suddenly and is not associated with other symptoms
      • Lasts 3 days, sometimes a day or two longer
    • Convulsions may occur in association with high fever in up to 5% to 10% of children
    • A rash that develops 12-24 hours after the fever
      • Appears on the chest and abdomen first
      • Rose-colored
      • May spread to arms, legs, neck, and face
      • Lasts for a few hours to a few days and does not itch
    • Other symptoms or signs may include:
      • Swelling of lymph nodes in the neck and behind the ears
      • Irritability
      • Poor appetite
      • Upper respiratory tract infection symptoms that may occur before the fever
    The appearance of a rash after the fever disappears is the characteristic sign of roseola.
  • Diagnosis

    The doctor will ask about symptoms and medical history. A physical exam will be done. Usually other tests are not needed. Often, there is a history of other children with roseola in the community.
  • Treatment

    No treatment is needed for roseola unless the child has a weakened immune system. The most important treatment is to keep the fever down and drink plenty of fluids.
    Talk to your doctor about how to bring the fever down through:
    • Medications such as acetaminophen or ibuprofen
    • Lukewarm sponge baths
    • Plenty of fluids
    • Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome. Ask your doctor which other medicines are safe for your child.
    Call your doctor if your child has a seizure and/or the fever persists.
  • Prevention

    To help prevent the spread of roseola, avoid contact with an infected child when possible. The incubation period is 5-15 days. The virus is thought to be spread by contact with infected saliva. Carefully and frequently wash your hands to help prevent the spread of roseola.

    American Academy of Family Physicians

    American Academy of Pediatrics


    About Kids Health

    Alberta Health


    Roseola infantum. American Academy of Pediatricians' Healthy Children website. Available at: Updated May 11, 2013. Accessed August 5, 2013.

    Roseola. Nemours' KidsHealth website. Available at: Updated July 2012. Accessed August 5, 2013.

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