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: Roseola is Common but Harmless
DEAR DR.PAUL: My 10 month old daughter
had a high fever for 3 days. After the 3rd day she woke up was
back to normal but had all these pinkish dots on her chest, back
and face. Her pediatrician diagnosed Roseola. What is Roseola?
DR.PAUL ANSWERS: This is actually a
very typical presentation of Roseola which is a childhood viral
infection also known as Exanthum Subitum or 6th disease. The good
news is that as with your baby, Roseola is self limiting in other
words, it that goes away in its own.
The Roseola virus tends to cause infections in children less than
2 years of age. This infection is rare in children less than 3
months or older than 4 years of age. Typically it causes fever
with a bit of irritability and no other obvious symptoms. The
fever characteristically lasts for up to 3 to 4 days and then
goes away on its own. At the same time a rash (usually on the
whole body) comes out. The Roseola rash usually lasts another
few days, but without fever. This is the distinguishing feature
of Roseola: the rash appears only after the fever breaks. So just
by this pattern in the history that you report, I can guess that
the diagnosis was Roseola, even without examining your child.
There are, of course, other viruses that cause fever and rash,
but none of them first presents with fever only and then a rash
once the fever subsides. Most of the other viral infections feature
rash and fever both occurring at the same time.
I have seen many cases of Roseola and most are straight forward.
However the situation can sometimes be complicated by the fact
the child was prescribed antibiotics at the time of the fever
for a "suspected bacterial infection". When the rash erupts we
are puzzled; Is the rash due to Roseola which may have caused
the fever in the first place, or is it an antibiotic allergic
reaction? Sometimes the type of rash helps us distinguish between
these two possibilities. Often there are some subtle physical
signs we see in Roseola. For example, the occipital lymph nodes
tend to be involved. These are the lymph nodes found at the base
of the skull (back of the head just above the neck). Typically
the occipital nodes are enlarged during Roseola infection.
The Roseola virus is thought to be spread, as other viruses, through
respiratory secretions. The incubation period, or the time between
exposure to the virus and actually developing symptoms, is between
5 to 14 days. Most cases of Roseola occur during the spring, summer
and fall periods. Once a child gets Roseola this infection does
not recur or come back. There is no specific treatment, except
for fever medication(Acetaminophen) as needed. Remember that Aspirin
or ASA should never be used in children. Additionally, no special
precautions or control measures are necessary for children or
adults who have come into in contact with someone with Roseola.
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replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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