Rash on baby face with fever

Causes and when to see a doctor

Toddlers can often get fevers when they are unwell, even when they have a cold or another minor illness. Several common childhood illnesses, including roseola and scarlet fever, can cause a rash to develop after the fever passes.

A fever is not a disease but a sign that the body’s immune system is fighting an infection. The body raises its core temperature to fight off the invading bacteria or viruses.

Children aged 1–3 years old, generally referred to as toddlers, often get illnesses because:

• their immune systems have not yet fully developed
• they have increased exposure to germs from other children, especially in day care or preschool
• they tend to put their hands or objects in their mouths

Fever usually goes away once the illness passes. However, toddlers sometimes develop a rash following a fever. Although this is rarely severe, it is important to see a doctor immediately.

In this article, we look at the possible causes of a rash after fever in toddlers, what to do about it, and when to see a doctor.

Several common childhood illnesses can cause a rash after fever. Most are not serious, but some do require medical treatment, so it is essential to discuss these symptoms with a doctor.

Common causes of post-fever rash in toddlers include:

Roseola infantum

Roseola infantum, which is also called roseola or sixth disease, is a viral infection. Babies and toddlers pass on the virus through saliva, coughing, and sneezing.

Roseola may cause a sudden, high fever of 102–105°F that lasts for 3–6 days. Some children are active and comfortable with no other symptoms during this stage of the illness, but others may also experience:

• decreased appetite or unwillingness to eat
• eye swelling or conjunctivitis, also known as pink eye
• a cough
• a runny nose
• diarrhea
• swollen lymph nodes
• sleepiness or irritability

Typically, the symptoms of roseola go away suddenly on the sixth or seventh day of illness. After these symptoms have cleared up, the rash appears.

In most cases, the roseola rash:

• consists of small pink spots, about 2–5 millimeters (mm) wide
• may be slightly raised or flat
• starts on the trunk and may spread to the arms, neck, and face
• does not itch or hurt
• disappears when pressed, which is known as blanching
• fades after 1–2 days

The incubation period for roseola is 7–14 days, which means that symptoms may not appear until 1–2 weeks after becoming infected. Antibiotics do not work against roseola, but extra fluids and fever-reducing medicine can relieve symptoms.

Parents and caregivers should keep children with roseola out of school or day care until they have been free of fever for 24 hours without the use of medication. The rash from roseola is not contagious.

Up to 15 percent of children with roseola may also experience a febrile seizure, which can happen as a result of the high fever and the ability of the virus to cross into the brain.

During a febrile seizure, the child may:

• lose consciousness
• start shaking their arms and legs uncontrollably
• become stiff
• roll their eyes
• wet or soil themselves
• vomit
• froth at the mouth

Febrile seizures generally only last a few minutes. According to the National Institute of Neurological Disorders and Stroke, there is no evidence that short febrile seizures cause brain damage. Most children will recover without any problems.

However, the parent or caregiver should immediately call an ambulance if:

• it is the child’s first febrile seizure
• the seizure lasts longer than 5 minutes
• the child has a stiff neck, is vomiting excessively, or is extremely lethargic

During the seizure, it is vital to:

• remain calm and time the length of the seizure
• carefully place the child in a safe location to protect them from accidental injury
• position the child on their side or front to prevent choking
• carefully remove any objects from the child’s mouth

Scarlet fever

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

Infected children can pass on the bacteria through:

• coughing and sneezing
• sharing food or drinks
• letting other people touch a skin lesion, where there is a skin infection

Symptoms of scarlet fever may include:

• a temperature of 101°F or higher
• red rash that starts on the neck, underarms, or groin area and spreads across the body
• red, sore throat
• white coating or red bumps on the tongue
• redness in skin creases, such as under the arms and inside the elbows and inner thighs
• a headache
• body aches
• nausea, stomach ache, or vomiting

The rash from scarlet fever feels rough like sandpaper. It usually appears 1–2 days after the fever starts but can present up to 7 days later.

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

A child with symptoms of scarlet fever should see a doctor as soon as possible. In rare cases, group A strep infections can cause severe complications, such as heart or kidney problems.

Doctors treat scarlet fever with antibiotics. A child may return to school or day care once they have been taking antibiotics for at least 24 hours.

Hand, foot, and mouth disease

Hand, foot, and mouth disease (HFMD) is common in children under 5 years old. Several different viruses can cause this illness, and children can pass on the infection through:

• saliva
• coughing and sneezing
• fluid from blisters
• poop

HFMD often starts with a fever, but it may also cause a sore throat, lack of appetite, and malaise.

After about 1–2 days, sores and a rash may appear. The telltale signs of HFMD include:

• sores in the back of the mouth that are small initially but turn into painful blisters
• flat, red spots on the palms of the hands or the soles of the feet
• flat, red spots or blisters on the buttocks or groin

Some toddlers might get all of these symptoms, while others may only get mildly sick without any other problems. A parent or caregiver should get advice from a doctor on when a child with scarlet fever should return to school or day care.

Although most cases of HFMD resolve on their own, the sores can be painful. If a child is unable to eat or drink, there is a risk of dehydration. Children who are not eating or drinking or who seem very ill should see a doctor.

Fifth disease

Fifth disease, known medically as erythema infectiosum, is a viral infection that commonly occurs in toddlers. Parvovirus B19 is the virus responsible for the infection, which spreads easily through coughing and sneezing.

Symptoms of fifth disease may include:

• fever
• a headache
• a runny nose

Fifth disease is sometimes called slapped cheek syndrome because the rash causes the cheeks to appear red. Some toddlers may get a red, blotchy rash on their trunk, buttocks, arms, and legs a few days after the redness becomes apparent in the cheeks.

The rash may cause itching and tends to form a lacy pattern as it starts to fade. It can last for several weeks.

Most children recover from fifth disease without any problems. However, both children and adults with weakened immune systems can develop long-term complications.

As it is a viral illness, antibiotics are not effective against fifth disease. Plenty of fluids, rest, and pain relievers may be beneficial.

Usually, children can go back to school or day care once they have been fever-free for at least 24 hours. The rash is not contagious.

Share on PinterestA pharmacist can offer advice about medication for children.

If a toddler is uncomfortable, medications that reduce pain and fever can relieve symptoms. Acetaminophen or ibuprofen are standard choices and are available over the counter (OTC).

When giving medication to a child:

• always follow the directions on the packaging carefully
• be sure to use the correct amount for the child’s age and weight
• if in doubt, check with a medical professional first

Encourage the child to drink plenty of fluids. Popsicles or children’s electrolyte drinks may be helpful if the child does not want water.

Fevers in toddlers are often due to illnesses that get better on their own. However, parents and caregivers should observe young children when they get a fever, rash, or other symptoms of an illness.

Call a doctor if a child of any age gets a rash after fever, or if the child is:

• younger than 3 months of age and has a rectal temperature of 100.4°F or higher
• aged 3–6 months and has a temperature of 102°F or higher
• over 6 months of age and has a fever of 103°F or higher

This is essential even if the child does not seem unwell.

Fever and rashes are common in toddlers. Most of the time, the child will recover without any long-term problems. However, it is important to monitor symptoms closely.

If symptoms become worse or do not go away, see a doctor. Parents and caregivers who have any concerns about a child’s illness should speak to a doctor.

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

Parental leaflet on viral diseases

Parental leaflet.

Measles is a viral infection with a very high susceptibility. If a person has not had measles or has not been vaccinated against this infection, then after contact with the patient, infection occurs in almost 100% of cases. The measles virus is highly volatile. The virus can spread through ventilation pipes and elevator shafts - at the same time, children living on different floors of the house get sick.

The period from contact with a person with measles to the appearance of the first signs of the disease lasts from 7 to 14 days.

The disease begins with a severe headache, weakness, fever up to 40 degrees C. A little later, a runny nose, cough and almost complete lack of appetite join these symptoms.

Very characteristic of measles is the appearance of conjunctivitis - inflammation of the mucous membrane of the eyes, which is manifested by photophobia, lacrimation, sharp redness of the eyes, and subsequently - the appearance of purulent discharge. These symptoms last 2 to 4 days.

On the 4th day of illness, a rash appears , which looks like small red spots of various sizes (from 1 to 3 mm in diameter), with a tendency to merge. The rash occurs on the face and head (it is especially characteristic of its appearance behind the ears) and spreads throughout the body for 3-4 days. It is very characteristic of measles that the rash leaves behind pigmentation (dark spots that persist for several days), which disappears in the same sequence as the rash appears.

Measles can cause serious complications . These include inflammation of the lungs (pneumonia), inflammation of the middle ear (otitis media), and sometimes such a formidable complication as encephalitis (inflammation of the brain).

It must be remembered that after suffering from measles for a sufficiently long period of time (up to 2 months), there is a suppression of immunity, so the child can get sick with some cold or viral disease, so you need to protect him from excessive stress, if possible from contact with sick children.

Long-lasting immunity develops after measles. All those who have had measles become immune to this infection.

The only reliable protection against the disease is vaccination against measles, which is included in the National Immunization Schedule.

Reminder for parents.

Rubella is an airborne viral infection. As a rule, children who stay in a water room for a long time with a child who is a source of infection get sick. Rubella in its manifestations is very similar to measles, but it is much easier.

The period from contact to the appearance of the first signs of illness lasts from 14 to 21 days.

Rubella begins with an increase in the occipital lymph nodes and an increase in body temperature up to 38 degrees C. A little later, a runny nose joins, and sometimes a cough. A rash appears 2 to 3 days after the onset of the disease. Rubella is characterized by a pink, punctate rash that begins with a rash on the face and spreads throughout the body. Rubella rash, unlike measles, never merges, there may be a slight itch. The period of rashes can be from several hours, during which there is no trace of the rash, up to 2 days.

The treatment of rubella is to relieve the main symptoms - the fight against fever, if any, the treatment of the common cold, expectorants.

Complications from rubella are rare.

After rubella, immunity also develops, re-infection is extremely rare, but can occur.

It is therefore very important to get the rubella vaccine, which, like the measles vaccine, is included in the National Immunization Schedule.

Note for parents.

Mumps (mumps) is a childhood viral infection characterized by acute inflammation in the salivary glands.

Infection occurs by airborne droplets. Susceptibility to this disease is about 50-60% (that is, 50-60% of those who were in contact and who were not ill and not vaccinated get sick).

It can take 11 to 23 days from contact with a sick mumps to the onset of illness.

Mumps begins with an increase in body temperature up to 39 degrees C and severe pain in or under the ear, worse when swallowing or chewing. At the same time, salivation increases. Swelling quickly grows in the area of ​​​​the upper part of the neck and cheeks, touching this place causes severe pain in the child. Unpleasant symptoms disappear within three to four days: body temperature decreases, swelling decreases, pain disappears.

However, quite often mumps ends inflammation in glandular organs such as pancreas (pancreatitis), gonads. Past pancreatitis in some cases leads to diabetes mellitus . Inflammation of the gonads (testicles) is more common in boys. This significantly complicates the course of the disease, and in some cases may result in infertility. In especially severe cases, mumps can be complicated by viral meningitis (inflammation of the meninges), which is severe.

After a disease, a strong immunity is formed, but complications can lead to disability.

The only reliable protection against the disease is vaccination against mumps, which is included in the National Immunization Schedule.

Reminder for parents.

Varicella (chickenpox) is a common childhood infection. Mostly young children or preschoolers are ill. Susceptibility to the causative agent of chickenpox (the virus that causes chickenpox refers to herpes viruses) is also quite high. About 80% of contact persons who have not been ill before develop chickenpox.

From the moment of contact with a patient with chickenpox until the first signs of the disease appear, 14 to 21 days pass.

The disease begins with a rash. Usually it is one or two reddish spots, similar to a mosquito bite. These elements of the rash can be located on any part of the body, but most often they first appear on the stomach or face. Usually the rash spreads very quickly - new elements appear every few minutes or hours. Reddish spots, which at first look like mosquito bites, the next day take the form of bubbles filled with transparent contents. These blisters are very itchy. The rash spreads throughout the body, to the limbs, to the scalp. In severe cases, there are elements of the rash on the mucous membranes - in the mouth, nose, on the conjunctiva of the sclera, genitals, intestines. By the end of the first day of the disease, the general state of health worsens, the body temperature rises (up to 40 degrees C and above). The severity of the condition depends on the number of lesions. If there are elements of the rash on the mucous membranes of the pharynx, nose and on the conjunctiva of the sclera, then pharyngitis, rhinitis and conjunctivitis develop due to the addition of a bacterial infection. Bubbles open in a day or two with the formation of sores, which are covered with crusts. Headache, feeling unwell, fever persist until new rashes appear. This usually happens within 3 to 5 days. Within 5-7 days after the last sprinkling, the rash disappears.

Treatment of chickenpox is to reduce itching, intoxication and prevent bacterial complications. The elements of the rash must be lubricated with antiseptic solutions (as a rule, this is an aqueous solution of brilliant green or manganese). Treatment with coloring antiseptics prevents bacterial infection of rashes, allows you to track the dynamics of the appearance of rashes. It is necessary to monitor the hygiene of the mouth and nose, eyes - you can rinse your mouth with a solution of calendula, the mucous membranes of the nose and mouth also need to be treated with antiseptic solutions.

Complications of chickenpox include myocarditis - inflammation of the heart muscle, meningitis and meningoencephalitis (inflammation of the meninges, brain matter), inflammation of the kidneys (nephritis). Fortunately, these complications are quite rare. After chickenpox, as well as after all childhood infections, immunity develops. Re-infection happens, but very rarely.

Reminder for parents.

Scarlet fever is the only childhood infection caused not by viruses but by bacteria (group A streptococcus). This is an acute disease transmitted by airborne droplets. Infection through household items (toys, dishes) is also possible. Children of early and preschool age are ill. The most dangerous in terms of infection are patients in the first two to three days of the disease.

Scarlet fever begins very acutely with fever up to 39 degrees C, vomiting, headache. The most characteristic symptom of scarlet fever is tonsillitis, in which the mucous membrane of the throat has a bright red color, swelling is pronounced. The patient notes a sharp pain when swallowing. There may be a whitish coating on the tongue and tonsils. The tongue subsequently acquires a very characteristic appearance ( “crimson ”) - bright pink and coarsely granular.

By the end of the first beginning of the second day of illness, 9 appears0003 the second characteristic symptom of scarlet fever is a rash. It appears immediately on several parts of the body, most densely located in the folds (elbow, inguinal). Its distinguishing feature is that the bright red punctate scarlatinal rash is located on a red background, which gives the impression of a general confluent redness. Pressing on the skin leaves a white line . The rash may be spread over the whole body, but there is always a clean (white) area of ​​skin between the upper lip and nose, and also the chin. Itching is much less pronounced than with chicken pox.