roseola

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Related to Exanthum subitum: erythema infectiosum, roseola infantum, scarlet fever, sixth disease, Kaposi Sarcoma

Roseola

 

Definition

Roseola is a common disease of babies or young children, in which several days of very high fever are followed by a rash.

Description

Roseola is an extraordinarily common infection, caused by a virus. About 90% of all children have been exposed to the virus, with about 33% actually demonstrating the syndrome of fever followed by rash.
The most common age for a child to contract roseola is between six and twelve months. Roseola infection strikes boys and girls equally. The infection may occur at any time of year, although late spring and early summer seem to be peak times for it.

Causes and symptoms

About 85% of the time, roseola is caused by a virus called Human Herpesvirus 6, or HHV-6. Although the virus is related to those herpesviruses known to cause sores on the lips or genitalia, HHV-6 causes a very different type of infection. HHV-6 is believed to be passed between people via infected saliva. A few other viruses (called enteroviruses) can produce a similar fever-then-rash illness, which is usually also called roseola.
Researchers believe that it takes about 5-15 days to develop illness after having been infected by HHV-6. Roseola strikes suddenly, when a previously-well child spikes an impressively high fever. The temperature may reach 106°F. As is always the case with sudden fever spikes, the extreme change in temperature may cause certain children to have seizures. About 5-35% of all children with roseola will have these "febrile seizures."
The most notable thing about this early phase of roseola is the absence of symptoms, other than the high fever. Although some children have a slightly reddened throat, or a slightly runny nose, most children have no symptoms whatsoever, other than the sudden development of high fever. This fever lasts for between three and five days.
Somewhere around the fifth day, a rash begins on the body. The rash is usually composed of flat pink patches or spots, although there may be some raised patches as well. The rash usually starts on the chest, back, and abdomen, and then spreads out to the arms and neck. It may or may not reach the legs and face. The rash lasts for about three days, then fades.
Very rarely, roseola will cause more serious disease. Patients so afflicted will experience significant swelling of the lymph nodes, the liver, and the spleen. The liver may become sufficiently inflamed to interfere with its functioning, resulting in a yellowish color to the whites of the eyes and the skin (jaundice). This syndrome (called a mononucleosis-like syndrome, after the disease called mononucleosis that causes many of the same symptoms) has occurred in both infants and adults.

Diagnosis

The diagnosis of roseola is often made by carefully examining the feverish child to make sure that other illnesses are not causing the temperature spike. Once it is clear that no pneumonia, ear infection, strep throat, or other common childhood illness is present, the practitioner usually feels comfortable waiting to see if the characteristic rash of roseola begins.

Treatment

There are no treatments available to stop the course of roseola. Acetaminophen or ibuprofen is usually given to try to lower the fever. Children who are susceptible to seizures may be given a sedative medication when the fever first spikes, in an attempt to prevent such a seizure.

Prognosis

Children recover quickly and completely from roseola. The only complications are those associated with seizures, or the rare mononucleosis-like syndrome.

Prevention

Other than the usual good hygiene practices always recommended to decrease the spread of viral illness, no methods are available to specifically prevent roseola.

Key terms

Jaundice — The development of a yellowish tone to the skin and the whites of the eyes, caused by poor liver function.
Mononuclosis — An infection which causes swelling of lymph nodes, spleen, and liver, usually accompanied by extremely sore throat, fever, headache, and intense long-lasting fatigue.

Resources

Books

Kohl, Steve. "Human Herpesvirus 6." In Nelson Textbook of Pediatrics, edited by Richard E. Behrman. Philadelphia: W. B. Saunders Co., 1996.

roseola

 [ro-ze´o-lah, ro″ze-o´lah] (L.)
1. any rose-colored rash.
roseola infan´tum a common acute disease caused by infection with the herpesvirusRoseolovirus. It usually occurs in children under two years old, coming on suddenly and disappearing in 3 to 5 days, leaving no permanent marks. Diagnosis is difficult because the sole early symptom, beyond irritability and drowsiness, is fever. There may be convulsions, and generally the fever is very high; 40°C (104°F) is not unusual. Despite the high fever, the disease is mild. Called also exanthem subitum.



As the fever subsides and the disease is apparently at an end, a rash breaks out, usually on the body. This is unlike the course of other childhood diseases such as measles, scarlet fever, and chickenpox, in which the rash is present during the most intense phase; the rash of roseola infantum lasts only a few days and may disappear within hours (often it is so transitory that it is missed). Treatment consists only of such standard measures as antipyretics and tepid sponge baths to allay the fever. Rest and fluids are also recommended.

Once it is over, the child is believed to be permanently immune from further attacks. Roseola is sometimes confused with rubella, but is distinguished by having no lymph node involvement. Blood antibody titers are sometimes used when symptoms appear, to determine which disease it is.
syphilitic roseola an eruption of rose-colored spots in early secondary syphilis.

ro·se·o·la

(rō-zē-ō'la, rō-zē'ō-lă), Although the correct pronunciation of this word is rose'ola, it is more often accented on the second-last syllable (roseola) in the U.S.
A symmetric eruption of small, closely aggregated patches of rose-red color caused by human herpesvirus-6.
See also: exanthema subitum.
Synonym(s): macular erythema
[Mod. L. dim. of L. roseus, rosy]

roseola

/ro·se·o·la/ (ro-ze´o-lah) (ro″ze-o´lah) [L.]
1. any rose-colored rash.

roseola infan´tum  exanthema subitum.
syphilitic roseola  eruption of rose-colored spots in early secondary syphilis.

roseola

(rō-zē′ə-lə, rō′zē-ō′lə)
n.
A rose-colored skin rash, sometimes occurring with diseases such as measles, syphilis, or scarlet fever.

ro·se′o·lar adj.

roseola

[rōzē′ələ]
Etymology: L, roseus
any rose-colored rash. See also roseola infantum.

roseola

Exanthem subitum Pediatrics An acute herpesvirus 6 infection of infants and young children–6 months to 2 yrs–characterized by a fever and skin rash with a spring and fall pattern of infection Incubation period 5–15 days; high fever 105ºF–generally responds well to acetaminophen, which may persist for 3–5 days and be accompanied by convulsions; between the 2nd and 4th day, the fever falls dramatically and a transient–hrs to 1 day–rash appears on trunk and spreads to limbs, neck, face. See Herpesvirus-6.

ro·se·o·la

(rō'zē-ō'lă)
A symmetric eruption of small, closely aggregated patches of rose-red color; caused by human herpesvirus type 6 and sometimes type 7.
See also: exanthema subitum
[Mod. L. dim. of L. roseus, rosy]

ro·se·o·la

(rō'zē-ō'lă)
Symmetric eruption of small, closely aggregated patches of rose-red color caused by human herpesvirus-6.
[Mod. L. dim. of L. roseus, rosy]

Patient discussion about roseola

Q. roseola high fever

A. roseola; any rose colored eruption of the skin--roseola is a viral infection of young children producing a fever which last three or four days after which temperatures drops to normal,a skin rash appears and the child becomes better---treated with meds that lower fever and stops the rash.

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