Roseole (exanthème subalterne)

Roseola is a viral illness of infants and young children characterized by high fever lasting several days followed by the sudden appearance of a rash as fever resolves ^[1][2]. The condition is most often caused by human herpesvirus 6, though other viruses may produce comparable presentations ^[1][2].

The illness generally begins with 3 to 4 days of high fever, after which a discrete rose-pink macular or maculopapular rash emerges on the trunk and spreads to the neck and proximal limbs, blanching on pressure and fading within days without sequelae ^[1][2]. Febrile seizures occur in a minority of affected children during the febrile phase ^[1][2]. Cervical or scalp lymphadenopathy may be observed, and most children remain alert and active despite fever ^[1][2].

Roseola is a common childhood infection, especially in infants and young children, and is common in children ages 3 months to 4 years, most commonly in those ages 6 months to 1 year ^[1]. It is also described as common in early childhood, with associated viruses spreading among close contacts ^[1].

The associated human herpesviruses spread among close contacts via saliva or respiratory secretions, with asymptomatic shedding by caregivers considered a likely route ^[1][2]. Hand hygiene reduces propagation of the causative viruses ^[1].

Careful handwashing can diminish transmission of the viruses responsible for roseola among close contacts ^[1].

1. 1 NIH MedlinePlus. Roseola: MedlinePlus Medical Encyclopedia [Internet]. cited 23 Oct 2026. Available from: https://medlineplus.gov/ency/article/000968.htm
2. 2 Leung AK et al. Roseola Infantum: An Updated Review. Curr Pediatr Rev. 2024. PMID: 36411550. doi: 10.2174/1573396319666221118123844. PubMed: https://pubmed.ncbi.nlm.nih.gov/36411550/