Roseola Infantum ((Exanthum subitum) is most commonly associated with Human Herpes Virus 6 (HHV-6) and less commonly with Human Herpes Virus 7 (HHV-7). These two viruses belong to the ß-herpesvirus subfamily, which also includes Cytomegalovirus (CMV).
The peak incidence is from 6 to 15 months of age.
These infants often present with a high fever and may appear toxic. There are minimal upper respiratory tract signs. These infants often undergo a septic work up to rule out a serious bacterial infection.
Physicians should carefully evaluate these patients and make sure, clinically, that they don't' have bacterial meningitis. These patients do not typically cry with movement, the anterior fontanelle is not bulging and they usually feed well. The signs associated with meningitis may not be present in children younger than 18 months.
When seen by professionals or emergency room physicians, these patients are frequently prescribed an antibiotic for a presumed "middle ear infection." I typically tell the parent that I suspect Roseola and I often play it safe by administering one dose of Ceftriaxione IM, and follow the patient carefully. A clinician must not miss the diagnosis of bacterial meningitis. I seldom perform an extensive work up on these infants. The appropriate clinical judgment is of utmost medical importance.
The fever may persist for a few days and typically resolves abruptly. Once afebrile, the rash appears. This rash may me subtle or extensive and may last up to 3 to 4 days. When parents see the rash, they readily think that his child has the measles.
Since the rash is systemic, I do not prescribe any topical creams. If a child develops a rash while on an antibiotic, the clinician must examine the child and properly document his findings. The rash associated with Roseola is often falsely attributed to the antibiotic.
Parents must be reassured that the rash associated with Roseola is benign and resolves without any medicine in a few days. I seldom use IBUPROFEN (Advil®/Motrin®) to treat a child's fever because of its associated potential toxicity. I usually recommend ACETAMINOPHEN (Tylenol® generic), and I inform parents that a fever is actually beneficial.
Luis Lomeli MD
Author: LuisLomeliMD
Popular Tags:
Mango Allergy Metal Allergy Milk Allergy Mold Allergy Morning Allergy Relief Mosquito Allergy MSG Allergy New Allergy Medicine New Allergy Medicines New Allergy Treatment Nut Allergy Oat Allergy Onion Allergy Peanut Allergy Penicillium Allergy Perfume Allergy Pet Allergy Pineapple Allergy Prawn Allergy Seafood Allergy Shrimp Allergy Sinus Allergy Skin Allergy Soy Allergy Strawberry Allergy Sugar Allergy Sun Allergy Titanium Allergy Tomato Allergy Toothpaste Allergy Tuna Allergy Tylenol Allergy Wheat Allergy Yeast Allergy Zantac Allergy Zyrtec Allergy Zyrtec For Allergy
Back
