Roseola infantum

Background

Normal dermal anatomy.

• Also known as Exanthem Subitum
• Likely caused by HHV-6

Herpes Virus Types

• HHV-1: Herpes Simplex Virus-1
  • Neonatal HSV
• HHV-2: Herpes Simplex Virus-2
  • Neonatal HSV
• Herpes B virus
• Varicella zoster virus
  • Varicella (Chickenpox)
  • Herpes zoster (Shingles)
    • Herpes zoster ophthalmicus
    • Herpes zoster oticus (Ramsay Hunt syndrome)
• HHV-6 (Roseola infantum)
• HHV-8 (Kaposi’s sarcoma)
• Epstein-Barr virus
• Cytomegalovirus

Clinical Features

Roseola on a 21-month-old girl

• 3-5d prodrome of high fever → then defervescence → then rash for 1-2d
• Rash - erythematous macular eruption of discrete, pink lesions
  • Mostly on neck, trunk, buttocks
  • No mucus membrane involvement
• Lymphadenopathy often present
• Often erythematous tympanic membranes
• May have sterile pyuria

Complications

• Seizures
  • Seizure can occur in a small number of infants and children during the febrile phase
• Aseptic meningitis
• Encephalitis
• Thrombocytopenic purpura

Differential Diagnosis

Pediatric Rash

• Atopic dermatitis
• Bed bugs
• Contact dermatitis
• Drug rash
• Erythema infectiosum (Fifth disease)
• Hand-foot-and-mouth disease
• Henoch-schonlein purpura (HSP)
• Herpangina
• Herpes simplex virus (HSV)
• Infectious mononucleosis
• Meningitis
• Measles
• Molluscum contagiosum
• Roseola infantum
• Rubella (German measles)
• Scabies
• Scarlet fever
• Smallpox
• Varicella (Chickenpox)

Evaluation

• Clinical diagnosis, based on history and physical exam

Management

• Supportive care

Disposition

• Discharge

See Also

• Pediatric Rashes