Viral Exanthems: Roseola


Also known as … Sixth Disease, Roseola Infantum, Exanthema Subitum or Three-day Fever.

What is Roseola?

Roseola is a viral disease that commonly affects infants and toddlers.

Roseola is most frequently caused by human herpes virus-6 (HHV-6) Despite containing the word ‘herpes’ this condition is not associated with cold sores.

Not all children who are infected with roseola display clinical symptoms. The main symptoms of Roseola include:

  • High fever up to 40°C that can last 3-5 days
  • Rash that starts after the fever has subsided.
    • Rose coloured flat or slightly raised spots on the neck and chest and then spreads to the trunk, forearms and sometimes the face
    • Red bumps can develop inside the mouth and back of the throat (Nagayama spots)
  • Other symptoms
    • Mouth ulcers
    • Runny nose
    • Puffy eyes
    • Ear infections
    • Raised lymph glands
    • Cough
    • Vomiting
    • Diarrhoea

Roseola is usually a self-limiting illness and children make a full recovery. Approximately 10% of children develop febrile seizures associated with the high fever. Some rare complications include meningitis, encephalitis and clotting disorders.

Your doctor will make a diagnosis based on the clinical features. Blood tests can confirm HHV-6 infection; however this is rarely required.

There is no treatment for roseola. Roseola usually improves on its own. Your Doctor may recommend you to rest, maintain fluid intake and take paracetamol to assist recovery.

Almost all individuals make a full recovery.

This information has been written by Dr Subashini Gnanendran, Dr Rachael Anforth and Dr Ramez Barsoum.

Published October 2020


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