Title:Roseola Infantum: An Updated Review
Volume: 20
Issue: 2
Author(s): Alexander Kwok-Chu Leung*, Joseph Ming-Chee Lam, Benjamin Barankin, Kin Fon Leong and Kam Lun Hon
Affiliation:
- Department of Pediatrics, The University of Calgary, Alberta Children’s Hospital, Calgary, Alberta, Canada
Keywords:
Exanthem subitum, febrile seizures, human herpesvirus-6, human herpesvirus -7, rash at defervescence, roseola infantum, sixth disease.
Abstract:
Background: Roseola infantum is a common viral disease that occurs during childhood
worldwide.
Objective: The purpose of this article is to familiarize pediatricians with the clinical manifestations,
evaluation, diagnosis, and management of roseola infantum.
Methods: A search was conducted in April, 2022, in PubMed Clinical Queries using the key terms
"roseola infantum" OR “exanthem subitum” OR “sixth disease”. The search strategy included all
clinical trials, observational studies, and reviews published within the past 10 years. Only papers
published in the English literature were included in this review. The information retrieved from the
above search was used in the compilation of the present article.
Results: Roseola infantum is a viral illness characterized by high fever that lasts 3 to 4 days, followed
by the sudden appearance of rash at defervescence. The disease occurs most frequently in
children between 6 months and 2 years of age. Human herpesvirus-6 (HHV-6) is the major cause of
roseola infantum, followed by HHV-7. Transmission of the infection most likely results from the
asymptomatic shedding of the virus in the saliva of the caregivers or other close contacts. Characteristically,
the rash is discrete, rose-pink in color, circular or elliptical, macular or maculopapular,
measuring 2 to 3 mm in diameter. The eruption is first seen on the trunk. It then spreads to the neck
and proximal extremities. Typically, the rash blanches on pressure and subsides in 2 to 4 days without
sequelae. Most children look well otherwise and appear to be happy, active, alert, and playful.
The diagnosis is mainly clinical. Febrile seizures occur in 10 to 15 % of children with roseola infantum
during the febrile period. In general, serious complications are rare and occur more often in individuals
who are immunocompromised. There is no specific treatment. An antipyretic may be used
to reduce fever and discomfort.
Conclusion: Roseola infantum is generally a benign and self-limited disease. Failure to recognize
this condition may result in undue parental fear, unnecessary investigations, delay in treatment for
conditions that mimic roseola infantum and complications from roseola infantum, unnecessary
treatment of roseola infantum per se, and misuse of healthcare expenditure.
