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Roseola Infantum

Roseola infantum (Exanthema subitum) is an acute, benign infection that affects infants and young children, typically between ages 6 months to 3 years.

Roseola affects both sexes equally and occurs year-round, mostly in spring and fall. Overt roseola is the most common exanthem in children under age 2; inapparent roseola (febrile illness without a rash) may affect the rest.

Causes

The disease is common in children 3 months to 4 years old, most commonly in those between 6 months and 1 year. It is caused by a virus, called human herpesvirus 6. It occurs throughout the year. The incubation period is 5 to 15 days. A fever lasting 3 days generally precedes the appearance of the rash, and may be as high as 105 degrees Fahrenheit. Febrile convulsions may occur when the fever is high.

Symptoms and Signs

The signs and symptoms of roseola include:

  • The child develops a high temperature of up to 40ºC, which usually lasts for a few hours, but may last three to five days.
  • As the temperature falls, a raised, red rash appears – first on the body and neck, and later on the face, arms and legs.
  • The rash lasts from a few hours to one or two days.
  • Roseola may also cause a fever without the rash.
  • Children with roseola recover fully, usually within a week.

Diagnostic tests

Roseola infantum is usually diagnosed clinically; the causative organism is present in saliva.

Treatment

Because roseola is self-limiting, treatment is supportive and symptomatic: antipyretic medications to lower fever and, if necessary, anticonvulsants to relieve seizures.

Prevention

The infection usually affects young children but rarely adults, it is thought that a bout of roseola in childhood may provide some lasting immunity to the illness. Repeat cases of roseola may occur, but they are not common.

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