Highlights & Basics
- Roseola is a common febrile viral illness of early childhood; it is usually caused by human herpesvirus (HHV)-6B and occasionally by HHV-7.
- Roseola is characterized by 3 to 7 days of fever, often high grade (>103.0°F [39.5°C]), followed by onset of a diffuse morbilliform rash that appears with defervescence of fever. The lesions are discrete 3- to 5-mm pink-red macules and papules that commonly begin on the neck and trunk and spread to the extremities.
- Roseola is usually a benign self-limited illness that has been associated with febrile seizures.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Kimberlin DW, Barnett ED, Lynfield R, et al. Human herpesvirus 6 (including roseola) and 7. In: Red Book: 2021-2024 report of the Committee on Infectious Diseases. 32nd ed. Itasca, IL: American Academy of Pediatrics; 2021.
Braun DK, Dominguez G, Pellett PE. Human herpesvirus 6. Clin Microbiol Rev. 1997;10:521-67.[Abstract][Full Text]
Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children: a prospective study of complications and reactivation. N Engl J Med. 1994 Aug 18;331(7):432-8.[Abstract][Full Text]
1. Yamanishi K, Okuno T, Shiraki K, et al. Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet. 1988;1:1065-7.[Abstract]
2. Ward KN. The natural history and laboratory diagnosis of human herpesviruses-6 and -7 infections in the immunocompetent. J Clin Virol. 2005;32:183-193.[Abstract]
3. Kimberlin DW, Barnett ED, Lynfield R, et al. Human herpesvirus 6 (including roseola) and 7. In: Red Book: 2021-2024 report of the Committee on Infectious Diseases. 32nd ed. Itasca, IL: American Academy of Pediatrics; 2021.
4. Zerr DM, Meier AS, Selke SS, et al. A population-based study of primary human herpesvirus 6 infection. N Engl J Med. 2005;352:768-76.[Abstract][Full Text]
5. De Bolle L, Naesens L, De Clercq E. Update on human herpesvirus 6 biology, clinical features, and therapy. Clin Microbiol Rev. 2005;18:217-45.[Abstract][Full Text]
6. Krug LT, Pellett PE. Roseolovirus molecular biology: recent advances. Curr Opin Virol. 2014;9:170-7.[Abstract][Full Text]
7. Adams MJ, Carstens EB. Ratification vote on taxonomic proposals to the International Committee on Taxonomy of Viruses (2012). Arch Virol. 2012 Jul;157(7):1411-22.[Abstract][Full Text]
8. Lusso P, Malnati M, De Maria A, et al. Productive infection of CD4+ and CD8+ mature T cell populations and clones by human herpesvirus 6. Transcriptional down-regulation of CD3. J Immunol. 1991;147:685-91.[Abstract]
9. Bland RM, Mackie PL, Shorts T, et al. The rapid diagnosis and clinical features of human herpesvirus 6. J Infect. 1998;36:161-5.[Abstract]
10. Braun DK, Dominguez G, Pellett PE. Human herpesvirus 6. Clin Microbiol Rev. 1997;10:521-67.[Abstract][Full Text]
11. Zerr DM. Human herpesvirus 6 (HHV-6) disease in the setting of transplantation. Curr Opin Infect Dis. 2012;25:438-44.[Abstract]
12. Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children: a prospective study of complications and reactivation. N Engl J Med. 1994 Aug 18;331(7):432-8.[Abstract][Full Text]
13. Huang CT, Lin LH. Differentiating roseola infantum with pyuria from urinary tract infection. Pediatr Int. 2013;55:214-8.[Abstract]
14. Asano Y, Yoshikawa T, Suga S, et al. Clinical features of infants with primary human herpesvirus 6 infection (exanthem subitum, roseola infantum). Pediatrics. 1994;93:104-8.[Abstract]
15. Primary Care Dermatology Society. Viral exanthems. Dec 2021 [internet publication].[Full Text]
16. Kainth MK, Caserta MT. Molecular diagnostic tests for human herpesvirus 6. Pediatr Infect Dis J. 2011;30:604-5.[Abstract]
17. Bertolani MF, Portolani M, Marotti F, et al. A study of childhood febrile convulsions with particular reference to HHV-6 infection: pathogenic considerations. Childs Nerv Syst. 1996;12:534-9.[Abstract][Full Text]
18. Ward KN. Human herpesviruses-6 and -7 infections. Curr Opin Infect Dis. 2005;18:247-52.[Abstract]
19. Rose C. Rubella and rubeola. Sem Perinatol. 1998;22:318-22.
20. Morag A, Ogra P. Enteroviruses. In: Nelson textbook of pediatrics. 16th ed. Philadelphia, PA: WB Saunders Co.; 2000:956-64.
21. Cohen JI. Epstein-Barr virus infection. N Engl J Med. 2000;343:481-92.[Abstract]
22. Pellett Madan R, Hand J, AST Infectious Diseases Community of Practice. Human herpesvirus 6, 7, and 8 in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9).[Abstract]
23. Zerr DM, Gupta D, Huang ML, et al. Effect of antivirals on human herpesvirus 6 replication in hematopoietic stem cell transplant recipients. Clin Infect Dis. 2002;34:309-17.[Abstract][Full Text]
24. Papadopoulou A, Gerdemann U, Katari UL, et al. Activity of broad-spectrum T cells as treatment for AdV, EBV, CMV, BKV, and HHV6 infections after HSCT. Sci Transl Med. 2014;6:242ra83.[Abstract][Full Text]
25. Hall CB, Long CE, Schnabel KC, et al. Human herpesvirus-6 infection in children: a prospective study of complications and reactivation. N Engl J Med. 1994 Aug 18;331(7):432-8.[Abstract]
26. Zerr DM, Gupta D, Huang ML, et al. Effect of antivirals on human herpesvirus 6 replication in hematopoietic stem cell transplant recipients. Clin Infect Dis. 2002;34:309-317.[Abstract][Full Text]
27. Baumann RJ, Duffner PK, Schneider S. Practice parameter: long-term treatment of the child with simple febrile seizures. American Academy of Pediatrics. Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics. 1999;103:1307-9.
28. Zerr DM. Human herpesvirus 6 and central nervous system disease in hematopoietic cell transplantation. J Clin Virol. 2006;37(suppl 1):S52-6.[Abstract]
