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Roseola Infantum

Synonyms of Roseola Infantum

  • Exanthem Subitum
  • Pseudorubella
  • Sixth Disease

Disorder Subdivisions

  • No subdivisions found.

General Discussion

Roseola Infantum is an acute infectious disorder of infants or very young children. Characterized by high fever and the appearance of a red skin rash, this disorder may resemble Rubella after the fever has disappeared. Seizures may also occur.

Symptoms

The incubation period before symptoms of Roseola Infantum appear is approximately 5 to 15 days. A high fever begins abruptly and usually lasts for 3 or 4 days without an obvious identifiable cause. Convulsions are common during this period. Low levels of white blood cells (leukopenia) may occur by the 3rd day. The spleen may be slightly enlarged. The fever usually breaks on the 4th day, and a characteristic rash of red spots or elevated (macular or maculopapular) spots appears. This rash may cover the chest and abdomen, although it often appears in a mild form on the face and extremities. Temperature returns to normal at this stage, and the child usually feels and acts well. In some cases, the rash may be so mild that it goes unnoticed.

Causes

In most affected infants and children, Roseola Infantum is caused by infection with a herpesvirus known as human herpesvirus 6 (HHV-6). Less commonly, the condition is thought to result from infection with human herpesvirus 7 (HHV-7). Although the infection is known to spread from person to person, the specific mode of transmission remains unknown.

Affected Populations

Roseola Infantum most commonly affects infants and children between the ages of six months and two years. The condition typically occurs during the spring and fall months and, in some cases, has been reported in local outbreaks.

Related Disorders

Symptoms of the following disorders can be similar to those of Roseola Infantum. Comparisons may be useful for a differential diagnosis:

Atypical Measles Syndrome (AMS) is most common among adolescents and young adults. This disorder was usually associated with prior immunization using the outdated killed measles vaccines, which are no longer in use. However, inoculation with live measles vaccine has also been known to precede development of AMS. Presumably, inactivated measles virus vaccines do not prevent mild virus infection and can sensitize patients so that disease expression is altered significantly. AMS may begin abruptly, with high fever, headache, abdominal pain, and coughing. The rash may appear one to two days after onset, often beginning on the extremities. Swelling (edema) of the hands and feet may occur. Pneumonia is not uncommon, and nodular dense areas in the lungs may persist for three months or longer.

Measles (Rubeola; Morbilli) is a highly contagious viral disease occurring primarily in children. The disease is characterized by fever, cough, acute nasal membrane discharge (coryza), inflammation of the lining of the eyelids (conjunctivitis), and eruption of small, irregular, bright red spots with a minute bluish or white speck in the center (Koplik's spots) on the inner cheeks or lips and a rash of elevated spots (maculopapular) spreading over the skin. Measles has become rare in the United States since the introduction of Measles vaccines. (For more information, use "Measles" as your search term in the Rare Disease Database.)

Rubella (German Measles) in children is a mild contagious viral disease characterized by swelling of lymph glands and a rash beginning on the face and neck which quickly spreads to the trunk and the extremities. If a woman contracts Rubella during the early months of pregnancy, a spontaneous abortion, stillbirth, or birth defects in the infant may result. (For more information, choose "Rubella" as your search term in the Rare Disease Database.)

Scarlet Fever is an infection caused by bacteria that usually affects the mouth/throat area (pharynx), but may also affect the skin or birth canal. Patients may experience headache, abdominal pain, nausea, and a skin rash. A reddish flush may be apparent on the face, chest and extremities, accompanied by tiny red spots in some cases. The disease is much milder now than in the past, and complications are rare with proper treatment.

Standard Therapies

Roseola Infantum usually spontaneously resolves within a few days. Therefore, treatment of the condition is primarily symptomatic and supportive. Such measures may include providing certain medications to help reduce fever (antipyretics), such as acetaminophen or ibuprofen. However, aspirin must be avoided, since there appears to be an association between the onset of Reye Syndrome and the use of aspirin in children or adolescents with certain viral illnesses. Reye Syndrome, a rare but potentially life-threatening condition, is primarily characterized by distinctive, fatty changes of the liver and sudden inflammation and swelling of the brain (acute encephalopathy). (For more information on this disorder, please choose "Reye" as your search term in the Rare Disease Database.)

According to reports in the medical literature, if infants or children are prone to experiencing convulsions, the administration of certain sedatives when there is a sudden onset of fever may be helpful in preventing convulsive episodes in association with Roseola Infantum.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

Roseola Infantum Resources

Organizations:

References

TEXTBOOKS
Nelson Textbook of Pediatrics, 15th Ed.: Richard E. Behrman, Editor; W.B. Saunders Company, 1996. Pp. 890-92.

JOURNAL ARTICLES
Tohyama M, Hashimoto K, Yasukawa M, Kimura H, Horikawa T, Nakajima K, Urano Y, Matsumoto K, Iijima M, Shear NH. Association of human herpesvirus 6 reactivation with the flaring and severity of drug-induced hypersensitivity syndrome.
Br J Dermatol. 2007 Nov;157(5):934-40. Epub 2007 Sep 13.

Caselli E, Di Luca D. Molecular biology and clinical associations of Roseoloviruses human herpesvirus 6 and human herpesvirus 7. New Microbiol. 2007 Jul;30(3):173-87.

Dyer JA. Childhood viral exanthems. Pediatr Ann. 2007 Jan;36(1):21-9.

Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures.
Pediatr Neurol. 2006 Sep;35(3):165-72.

Identification of Human Herpes Virus-6 as a Causal Agent for Exanthem Subtum. K. Yamanishi et al.; Lancet (May 14 1988; 1(8594)). Pp. 1065-67.

Five Cases of Thrombocytopenia Induced by Primary Human Herpes Virus 6 Infection. T. Yoshikawa et al.; Acta Paediatr Jpn (Jun 1998; 40(3)). Pp. 278-81.

Risk Factors for the Early Acquisition of Human Herpes Virus 6 and Human Virus 7 Infections in Children. B.P. Lanphear et al.; Pediatr Infect Dis J (Sep 1998; 17(9)). Pp. 792-95.

HHV 6,7 AND 8. Recently Discovered Herpes Viruses Explain the Etiology of Well-Known Diseases. T. Bergstrom Lakartidningen (Jun 30 1999; 96(26-27)). Pp. 3161-65.

Human Herpes Virus 6: An Emerging Pathogen. G. Campadelli-Fiume et al.; Emerg Infect Dis (May-Jun 1999; 5(3)). Pp. 353-66.

The information in NORD’s Rare Disease Database is for educational purposes only. It should never be used for diagnostic or treatment purposes. If you have questions regarding a medical condition, always seek the advice of your physician or other qualified health professional. NORD’s reports provide a brief overview of rare diseases. For more specific information, we encourage you to contact your personal physician or the agencies listed as “Resources” on this report.

Report last updated: 2009/05/15 00:00:00 GMT+0

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