Roseola is a common viral illness of babies and toddlers, mostly caused by human herpesvirus 6. A few days of high fever end suddenly, and then a pink rash appears as the child starts to feel better.
Key symptoms
- High fever for 3 to 5 days in a child 6 months to 2 years old
- Fussiness, mild runny nose or diarrhea
- Pink rash on the trunk after the fever goes away
- Febrile seizure in some children
What you find on exam
- Child looks fairly well despite the high fever
- Small pink spots or bumps that fade with pressure and do not itch
- Swollen lymph nodes in the neck
- Red spots on the soft palate in some children
Tests
- Usually a clinical diagnosis
- Urinalysis in young febrile infants to look for urinary infection
- Blood tests only if the child looks unwell
Treatment basics
- Fluids and rest
- Acetaminophen or ibuprofen for comfort
- Teach parents what to do during a febrile seizure
- No treatment needed for the rash; return to childcare once fever-free
Red flags
- Seizure lasting longer than 5 minutes
- Child who is hard to wake or very floppy
- Signs of dehydration or a rash that does not fade with pressure
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.