Roseola Infantum

Roseola infantum, also known as exanthema subitum or sixth disease, is an acute, benign viral infection that usually affects infants and young children ages 6 months to 2 years, with the peak incidence between 9 and 12 months. Maternal antibodies usually prevent newborns from contracting the illness.

Characteristically, roseola first appears as an upper respiratory illness followed by high fever for 3 to 5 days. The high fever commonly ends abruptly at about the same time a rash develops.

Causes

Human herpesvirus 6 (HHV-6) causes roseola. The virus is spread directly through droplets when an infected person coughs or sneezes or indirectly through contact with respiratory secretions. It can also be spread through contact with oral secretions.

Complications

The major complication of roseola is seizures. Rarely, roseola may cause other central nervous system (CNS) complications, such as meningoencephalitis, encephalitis, bulging anterior fontanels, and hemiplegia. HHV-6 has been associated with chronic fatigue syndrome and possibly multiple sclerosis. Exanthem subitum/roseola syndrome may develop with primary infection and cause otitis media, respiratory distress, and gastroenteritis.

However, the virus remains latent and can seriously affect immune-compromised patients. Patients with a history of organ transplantation may develop bone marrow suppression, hepatitis, pneumonitis, or encephalitis. Patients with acquired immuno-deficiency syndrome may develop lymphadenopathy, disseminated organ involvement, CNS infection retinitis, and viremia. These complications may be fatal.