Rash from fever in infants

Roseola (for Parents) - Nemours KidsHealth

What Is Roseola?

Roseola (roe-zee-OH-lah) is a viral illness that most commonly affects young kids between 6 months and 2 years old. It's also known as sixth disease, exanthem subitum, and roseola infantum.

It is usually marked by several days of high fever, followed by a distinctive rash just as the fever breaks.

Two common, closely related viruses can cause roseola, human herpesvirus (HHV) type 6 and type 7. These viruses belong to the same family as the better-known herpes simplex viruses (HSV), but do not cause the cold sores and genital herpes infections that HSV can cause.

What Are the Signs & Symptoms of Roseola?

Most children with roseola develop a mild upper respiratory illness, followed by a high fever (often higher than 103°F or 39.5°C) for up to a week. During this time, a child might be fussy or irritable, not eat as much as usual, and may have swollen lymph nodes (glands) in the neck.

The high fever often ends abruptly, and at about the same time a pinkish-red flat or raised rash starts on the trunk. The rash's spots turn white when touched, and individual spots may have a lighter "halo" around them. The rash usually spreads to the neck, face, arms, and legs.

This fast-rising fever can trigger febrile seizures (convulsions caused by high fevers) in about 10% to 15% of young children who have roseola. Signs of a febrile seizure include:

unconsciousness
2 to 3 minutes of jerking or twitching in the arms, legs, or face
loss of control of the bladder or bowels

Is Roseola Contagious?

Roseola is contagious. The infection spreads when a child with roseola talks, sneezes, or coughs, sending tiny droplets into the air that others can breathe in. The droplets also can land on surfaces; if other children touch those surfaces and then their nose or mouth, they can become infected.

Roseola may be contagious during the fever phase, but does not spread by the time the rash breaks out.

Can Roseola Be Prevented?

There is no known way to prevent roseola. But because it affects young kids rather than adults, it's thought that a bout of roseola in childhood may provide some lasting immunity to the illness. Repeat cases of roseola can happen, but are uncommon.

How Long Does Roseola Last?

The fever of roseola lasts from 3 to 7 days, followed by a rash lasting from hours to a few days.

How Is Roseola Diagnosed?

To make a diagnosis, a doctor will take a

medical historyand do an exam. A diagnosis of roseola is often uncertain until the fever drops and the rash appears, so the doctor may order tests to make sure that the fever is not caused by another type of infection.

How Is Roseola Treated?

Roseola usually does not require professional medical treatment. When it does, most treatment is focused on lowering the high fever. Antibiotics can't treat roseola because viruses, not bacteria, cause it.

Home Treatment

Acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) can help to ease a fever. Never give aspirin to a child who has a viral illness because its use in such cases has been associated with Reye syndrome, which can lead to liver failure and death.

While some parents use lukewarm sponge baths to lower fever, there is no proof that this really works. In fact, sponge baths can make children uncomfortable. Never give your child an icy or cold bath or alcohol rubs.

To prevent dehydration from the fever, encourage your child to drink clear fluids such as water with ice chips and Pedialyte (electrolyte oral replacement solution). Breast milk and formula can help prevent dehydration as well.

When Should I Call the Doctor?

Call the doctor if your child is lethargic or won't drink or breastfeed. If your child has a seizure, get emergency care right away.

Reviewed by: Julio E. Pajaro, MD

Date reviewed: January 2019

Roseola-Viral Rash

Is this your child's symptom?

Widespread fine pink rash caused by Roseola virus
Classic feature is that the rash is preceded by 3 to 5 days of high fever
The fever goes away before the rash starts
A doctor has told you that your child probably has Roseola or
Rash occurs after several days of fever. Fever gone now and your child feels fine.

Symptoms of Roseola

Most children get Roseola between 6 months and 3 years of age.
Rash: Pink, small, flat spots on the chest and stomach. Rash is the same on both sides of the body. Then may spread to the face and arms.
Classic feature: 3 to 5 days of high fever without a rash or other symptoms.
The rash starts 12 to 24 hours after the fever goes away.
The rash lasts 1 to 3 days.
By the time the rash appears, the child feels fine.

Cause of Roseola

Human herpes virus 6 (HHV6)

Viral Rashes and Drug Rashes

Prescription drugs sometimes cause widespread rashes.
Non-prescription (OTC) drugs rarely cause any rashes.
Most rashes that occur while taking an OTC drug are viral rashes.
Fever medicines (acetaminophen and ibuprofen) cause the most confusion. Reason: Most viral rashes start with a fever. Hence, the child is taking a fever med when the rash starts. But, the fever med had nothing to do with the rash.
Drug rashes can't be diagnosed over the phone.

Prevention

Good hand washing can prevent spread of infection.

When to Call for Roseola-Viral Rash

Call 911 Now

Rash becomes purple or blood-colored with fever
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Large blisters on skin
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Fever comes back
Rash becomes worse
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Rash lasts more than 4 days
You have other questions or concerns

Self Care at Home

Roseola rash

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle

Care Advice for Roseola

What You Should Know About Roseola:
- Most children get Roseola between 6 months and 3 years of age.
- It's the most common rash in this age group.
- By the time they get the rash, the fever is gone. The child feels fine.
- The rash is harmless and goes away on its own.
- Here is some care advice that should help.
Treatment:
- No treatment is needed.
- Creams or medicines are not helpful.
Moisturizing Cream for Itch:
- Roseola usually is not itchy. If your child's rash is itchy, here are some tips.
- Use a moisturizing cream (such as Eucerin) once or twice daily.
- Apply the cream after a 5 or 10-minute bath. (Reason: Water-soaked skin feels less itchy).
- Avoid all soaps. (Reason: Soaps, especially bubble bath, make the skin dry and itchy).
Fever Medicine:
- For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Note: Fevers less than 102° F (39° C) are important for fighting infections.
- For all fevers: Keep your child well hydrated. Give lots of cold fluids.
- Note: By the time the rash occurs, the fever should be gone. If your child has both, see Rash or Redness - Widespread care guide.
What to Expect:
- Roseola rash goes away in 2-3 days.
- Some children with Roseola just have 3 days of fever without a rash.
Return to Child Care:
- Once the fever is gone for 24 hours, the disease is no longer contagious (AAP).
- Your child can return to child care or school, even if the rash is still present.
- Children exposed to your child earlier may come down with Roseola in 9-10 days.
Call Your Doctor If:
- Fever comes back
- Rash lasts more than 4 days
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 01/07/2023

Last Revised: 12/30/2022

Rash after fever in children. Treatment of rash in children. - FxMed

Young children often get viral infections accompanied by high fever. Some common childhood illnesses, including roseola and scarlet fever, which appear after a fever has passed, are accompanied by a rash.

Fever is not a disease, but a sign that the body's immune system is fighting infection. The body raises its temperature to fight invading bacteria or viruses. nine0003

Children aged 1-3 often get sick because:

their immune system is not yet fully developed
they constantly come into contact with a large number of viruses, especially in school and preschool institutions
they often put dirty hands or other foreign objects into their mouths

What are the most common illnesses in children that are accompanied by a rash after a fever?

Several common childhood illnesses may be accompanied by a rash after a fever. Most of them have a favorable course, but some require medical treatment, so it is important to discuss these symptoms with your doctor. nine0003

Roseola infantum or sixth disease

Roseola infantum, also called roseola or sixth disease, is a viral infection. Babies and toddlers transmit the virus through saliva, coughs and sneezes.

Roseola can cause a sudden high fever of 38-39°C that lasts 3-6 days. Most children are active and have no other signs or symptoms at this stage of the illness, but some children may experience:

decreased appetite and refusal to eat
eye swelling or conjunctivitis
cough
runny nose
stool disorder
swollen lymph nodes
drowsiness or irritability.

As a rule, body temperature returns to normal on the third or fourth day of illness. After that, a rash appears.

In most cases, the rash of roseola:

consists of small pink spots, about 2-5 mm wide (mm)
can be slightly raised or flat
starts on the body and may spread to the arms, neck and face
does not itch, does not hurt
disappears when
resolves on its own in 1-2 days

The incubation period for roseola is 7-14 days, meaning that symptoms may appear up to 1-2 weeks after infection. For treatment, antipyretic drugs and a large amount of liquid are used. Antibiotics for roseola are not used.

The virus that causes roseola has a neurotropic effect, so children often become irritable, whiny and sleepy. nine0003

Scarlet fever

Scarlet fever is a highly contagious disease that spreads from person to person.

Scarlet fever results from infection with group A Streptococcus bacteria. This type of bacteria can also cause oropharyngeal infections and specific skin infections such as impetigo.

Infected children can shed the bacteria through:

coughing and sneezing
sharing meals or drinks
touching infected areas of the skin of a sick person

Symptoms of scarlet fever may include:

fever of 38 or more
a red rash that starts on the neck, armpits, or groin area and spreads throughout the body
red "burning" throat, sore throat
white coating on the tongue
redness in skin folds, e. g. under the arms and inside the elbows and inner thighs
headache
body aches
nausea, abdominal pain or vomiting

Rash in scarlet fever rough, skin feels like sandpaper. It usually appears 1-2 days after the onset of fever, but may appear on the 7th day.

The area around the mouth usually remains pale, even if the rest of the face appears red. After the rash has gone, the skin may peel off.

A child with symptoms of scarlet fever should see a doctor as soon as possible. Rarely, group A streptococcal infections can cause serious complications, such as heart or kidney problems. nine0003

Most cases of scarlet fever are treated with antibiotics.

Hand-foot-mouth disease

Hand-foot-mouth disease is common in children under 5 years of age. Several different viruses can cause this illness, but the most common are enterovirus infections, such as Coxsackievirus and children can become infected through:

saliva
coughing and sneezing
vial liquid

Hand-foot-mouth disease often begins with fever, but may also present with sore throat, anorexia, and malaise. nine0003

Approximately 1-2 days after the onset of the disease, ulcers and a rash may appear.

Characteristic signs of the rash include:

mouth sores that are initially small but develop into painful blisters
flat, red patches on palms or soles
flat, red spots or blisters on the buttocks or groin

Although most enterovirus rashes resolve spontaneously, ulcers can be painful. If a child cannot eat or drink, there is a risk of dehydration. Children who do not eat or drink, are lethargic and drowsy, should be examined by a doctor immediately. nine0003

Fifth disease

Fifth disease, or erythema infectiosum, is a viral infection that usually occurs in children in the first 3 years of life. Parvovirus B19 is a virus that is spread through the air through sneezing or coughing.

Symptoms of the fifth disease may include:

fever
headache
runny nose

Redness of the cheeks is a characteristic symptom of this disease. In a small percentage of children, a red, patchy rash can be seen on the chest, buttocks, arms, and legs a few days after the cheeks turn red. nine0003

The rash may be itchy, tends to form a lacy pattern, and may last for several weeks.

The fifth disease goes away without a trace in most children. However, complications can develop in children and adults with weakened immune systems.

Since this is a viral disease, antibiotics are not effective. Plenty of fluids, rest, and antipyretic drugs are treatments that have proven effective.

How to treat diseases that are accompanied by a rash after a fever? nine0019

When giving medicine to a child:

be sure to consult a doctor
always follow the instructions on the package
do not exceed the maximum age dose of the drug

Encourage your child to drink enough fluids.

In most cases, the child will recover without any complications. However, it is important to monitor symptoms closely.

If symptoms worsen or do not disappear, do not postpone a visit to the pediatrician or family doctor

Roseola or three-day fever

Alexey Shaposhnikov

Dermatologist

April 25, 2021

Roseola infantum has many names: sudden exanthema, three-day fever, pseudorubella . In many cases, it is not diagnosed as a separate disease, when the temperature rises, a diagnosis of ARVI is made, the rash is attributed to an allergy to medications taken during the illness. nine0003

What is baby roseola?

Roseola in childhood is a viral disease characterized by a sudden rise in temperature, and then, after its decrease, the appearance of a small pink rash that spreads throughout the body. In the first three days, before the appearance of rashes, it is difficult to make a diagnosis, since apart from the temperature there are no characteristic symptoms. It is the appearance of the rash that helps determine that it is roseola.

This infection is transmitted presumably by airborne droplets, incubation period 9-12 days. Laboratory confirmation of the diagnosis is not required, and, as a rule, no tests are performed. Usually sick children from 6 months to 3 years, mainly in the spring-autumn period.

What pathogen causes this disease?

Most often, roseola is caused by the human herpes virus type 6, rarely type 7. Herpes virus 6 (HHV-6) is very widespread; at birth, babies have antibodies from their mother that protect it. Their levels are significantly reduced by 4 months, and the child becomes susceptible to infection. After 2 years, the immune system can already quite successfully cope with the virus, preventing the development of an acute illness. But in the interval, the body of children is most vulnerable, the peak incidence occurs at 6-12 months. nine0003

There is no specific prevention of roseola, among the general measures that reduce the risk of the disease, one can note regular airing of the rooms where the child is located, limiting close bodily contact with adults (do not kiss a small child on the lips, nose, lick spoons and nipples, etc. Further).

After the illness, persistent immunity is developed , cases of re-infection are quite rare, but sometimes they occur. After 4 years, almost all examined children have antibodies to this virus. nine0003

Characteristic signs of the disease?

Temperature rise to 38°C-40°C without respiratory symptoms (runny nose, cough, sore throat) and rash. An increase in temperature is the body's reaction to the presence of a virus in the blood. On average, the temperature lasts 3 days.
Eruption of small pale pink spots, predominantly on the neck and trunk, to a lesser extent on the face and extremities, 1-2 days after the fever has ceased. Often around the elements of the rash you can see a pale rim. nine0012
The rash does not itch and resolves on its own within a few days or weeks.

How is roseola different from rubella?

With rubella, the rash appears at the same time as the temperature, is located mainly on the extremities, is slightly different in appearance. Also, rubella is not characterized by such a sharp and high rise in temperature.

Are there complications?

In the vast majority of cases, the body copes on its own and without consequences. High fever with sudden exanthema can cause febrile convulsions . As a rule, they are not dangerous, pass without consequences for the child and are not associated with damage to the nervous system or brain. But, if this happened for the first time, the child should be examined by a neurologist.

Sometimes there are concomitant symptoms in the form of inflammation in the nasopharynx and swollen lymph nodes. Very rarely, with an appropriate predisposition, neurological complications of the disease are possible: encephalitis, meningitis.

How to treat roseola?

The child should be examined by a pediatrician, as a high temperature can be not only with roseola, but also with other infectious diseases that require treatment, such as otitis media, urinary tract infections.

There is no specific treatment for the virus that causes roseola, so the treatment is symptomatic: antipyretics at high temperatures to relieve the child's condition. While the temperature is holding, it is important to ensure that the child consumes enough fluids. If the child refuses to eat, you do not need to force feed, as soon as the condition improves, the appetite will return. nine0003

When a rash appears, it is not necessary to lubricate it with something or take antiallergic drugs. The spots disappear on their own, leaving no traces, a slight peeling of the skin is possible, which also disappears without treatment. The child during this period can be bathed. After bathing, there may be an increase in the brightness of the rash due to the flow of blood to the skin, this is a temporary phenomenon that does not worsen the course of the disease.

Antiviral treatment is given for severe disease, usually in immunocompromised children. When treating patients with immunodeficiency, consultation of a pediatric infectious disease specialist is necessary.