Roseola Infantum - Causes, Symptoms and Treatments

Also called exanthema subitum, roseola infantum is an acute, benign, presumably viral infection. It usually affects infants and young children (ages 6 months to 3 years).

Roseola affects boys and girls alike. It occurs year-round but is most prevalent in the spring and fall. Overt roseola, the most common exanthem in infants under age 2, affects 30% of all children; inapparent roseola (febrile illness without a rash) may affect the rest.

Characteristically, roseola first causes a high fever and then a rash that accompanies an abrupt drop to normal temperature.

Causes of Roseola Infantum:

The mode of transmission isn't known. Only rarely docs an infected child transmit roseola to a sibling.

Signs and symptoms of Roseola Infantum:

After a 10- to 15-day incubation period, the infant with roseola develops an abruptly rising, unexplainable fever and, sometimes, seizures. Temperature peaks at 103° to 105° F (39.4° to 40.6° C) for 3 to 5 days, then drops suddenly. In the early febrile period, the infant may be anorexic, irritable, and listless but doesn't seem particularly ill.

Simultaneously with an abrupt drop in temperature, a maculopapular, nonpruritic rash develops, which blanches on pressure. The rash is profuse on the infant's trunk, arms, and neck, and is mild on the face and legs. It fades within 24 hours. Although possible, complications are extremely rare.

Diagnosis of Roseola Infantum:

Diagnosis requires observation of the typical rash that appears about 48 hours after fever subsides. Other conditions to consider are varicella, rubeola, rubella, and herpes simplex.

Treatment of Roseola Infantum:

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

Prevention tips of Roseola Infantum:

Teach parents how to lower their infant's fever by giving tepid baths, keeping him in lightweight clothes, and maintaining normal room temperature. Stress the need for adequate fluid intake. Strict bed rest and isolation are unnecessary. Tell parents that a short febrile convulsion will not cause brain damage. Explain that convulsions will cease after fever subsides and that phenobarbital is likely to cause drowsiness; parents should call immediately if it causes stupor.