What is roseola infantum (exanthema subitum)?

From the Guidelines

Roseola infantum is a common viral infection primarily affecting infants and young children, characterized by a high fever followed by a distinctive rash, and is typically caused by human herpesvirus 6 (HHV-6) or human herpesvirus 7 (HHV-7). The infection is marked by a sudden onset of high fever, often above 103°F (39.4°C), lasting for 3-5 days, and then a rose-pink rash appears as the fever subsides, usually starting on the trunk and spreading to other parts of the body 1. Key characteristics of roseola infantum include:

• High fever that lasts for several days
• A distinctive rash that appears after the fever breaks
• The rash typically starts on the trunk and then spreads
• The illness is usually self-limiting and resolves within a week
• It is primarily caused by HHV-6 or HHV-7
• Treatment is supportive, focusing on managing symptoms such as fever and preventing dehydration, with medications like acetaminophen or ibuprofen used appropriately for the child's weight. Although the provided study 1 discusses a case where roseola infantum was diagnosed alongside pneumonia, the primary concern in managing roseola infantum remains the alleviation of symptoms and the prevention of complications such as dehydration and febrile seizures.

From the Research

Definition and Characteristics of Roseola Infantum

• Roseola infantum is a common viral disease that occurs during childhood worldwide 2.
• It is characterized by high fever that lasts 3 to 4 days, followed by the sudden appearance of rash at defervescence 2, 3.
• The disease occurs most frequently in children between 6 months and 2 years of age 2.
• The rash is discrete, rose-pink in color, circular or elliptical, macular or maculopapular, measuring 2 to 3 mm in diameter 2.

Causes and Transmission of Roseola Infantum

• Human herpesvirus-6 (HHV-6) is the major cause of roseola infantum, followed by HHV-7 2, 4.
• Transmission of the infection most likely results from the asymptomatic shedding of the virus in the saliva of the caregivers or other close contacts 2.

Clinical Presentation and Diagnosis

• The eruption is first seen on the trunk, then spreads to the neck and proximal extremities 2.
• Typically, the rash blanches on pressure and subsides in 2 to 4 days without sequelae 2.
• Most children look well otherwise and appear to be happy, active, alert, and playful 2.
• The diagnosis is mainly clinical 2.
• Febrile seizures occur in 10 to 15 % of children with roseola infantum during the febrile period 2.

Treatment and Complications

• There is no specific treatment for roseola infantum 2, 4.
• An antipyretic may be used to reduce fever and discomfort 2.
• Serious complications are rare and occur more often in individuals who are immunocompromised 2, 4.