An 18 month old female came into the hospital following two seizure episodes. At the time of the fever she had a very high fever, 104, but no other symptoms and the patient had no history of seizures or illness. The patient had no subsequent seizures and the fever subsided. The next day the patient began getting a rash on her face which spread to her body.
A 19 month old female came into the office with a diffuse rash. Two days before the rash began she had a high fever, 103, for about 24 hours. The patient had no other symptoms. The rash began after the fever subsided and was a diffuse maculopapular rash covering her face, trunk, and proximal extremities. The rash became worse in warm water.
These two patients had the same disease - Roseola Infantum, also known as Sixth Disease. This is a viral illness common in infants, caused by Human Herpes Virus 6.
Typically, the young patient has a fever with no other symptoms. Sometimes, in about 15% of patients, the high fever causes febrile seizures. The fever will go away after 3-7 days and a rash begins. The rash of Roseola is a blanchable maculopapular rash covering the face, trunk, and proximal extremities. The rash goes away within hours to days.
There is no specific treatment for roseola; it is a viral infection. It is a very common disease and only supportive treatment is necessary. This includes tylenol or motrin for fevers, especially if febrile seizures are likely (based on previous episodes), as well as making sure the child stays hydrated.