From the Research
Roseola infantum in a 1-year-old girl typically follows a predictable pattern over about 7-10 days, starting with a sudden high fever that persists for 3-4 days, followed by the appearance of a rash upon defervescence, as described in the most recent review 1. The illness usually begins with a high fever (103-105°F/39.5-40.5°C) that lasts for 3-4 days, during which the child may appear irritable, have decreased appetite, mild cough, runny nose, and swollen lymph nodes behind the ears and neck. Despite the high fever, the child might remain surprisingly alert and active.
- Key symptoms during the febrile phase include:
- High fever
- Irritability
- Decreased appetite
- Mild cough
- Runny nose
- Swollen lymph nodes
- Around days 3-5, the fever typically breaks suddenly, and within 12-24 hours, a distinctive pinkish-red, non-itchy rash appears, starting on the trunk and spreading to the neck, face, arms, and legs, as noted in a recent case report 2.
- The rash consists of small, flat or slightly raised spots that may temporarily whiten when pressed, and usually lasts 1-2 days before fading without treatment.
- Throughout the illness, it is essential to ensure the child stays well-hydrated with frequent breast milk, formula, or water offerings.
- Roseola is caused by human herpesvirus 6 (HHV-6) or occasionally HHV-7, and spreads through respiratory droplets and saliva, as discussed in a review of the clinical manifestations and management of roseola infantum 1.
- The illness is generally mild and self-limiting, requiring only supportive care, and most children recover without significant sequelae, as supported by the latest research 1. It is crucial to contact a doctor immediately if the child experiences seizures, extreme lethargy, persistent irritability, or if the fever lasts more than 5 days, as these can be signs of complications or other underlying conditions, as highlighted in a study on the clinical impact of primary infection with roseoloviruses 3.