What is Exanthema Subitum?

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  • Written By: Deborah Walker
  • Edited By: R. Halprin
  • Last Modified Date: 29 September 2019
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Exanthema subitum, also known as roseola or sixth disease, is a viral illness that affects children between six and 24 months. It is most often spread through the mucous of a non-symptomatic baby. The initial symptom associated with exanthema subitum is a sudden, high fever that lasts up to four days. The baby may have enlarged lymph nodes, a red, non-itchy rash, and may be fussy and refuse to eat; a cough, sore throat, diarrhea, or vomiting is sometimes, but not often, associated with this illness. Roseola may be treated symptomatically and does not usually cause any long-term problems for the baby.

The viruses responsible for exanthema subitum belong to the herpes family and are not related to the rubella, or German measles, virus. Roseola is rarely seen in children over four years of age, although there has been at least one documented case of an 18-year-old contracting it. When a person is exposed, the virus incubates for about 10 days.


Once the incubation period has passed, the baby will spike a fever between 103°-106° Fahrenheit (39.4°-41.2° Celsius). Sometimes the high fever may cause the baby to have a febrile seizure. Aside from the fever, the baby may be generally irritable or have a decreased appetite. Caregivers may notice swollen lymph nodes under the arms or at the top of the neck near the chin. Sometimes babies develop a cough, sore throat, and other cold- or flu-like symptoms, but the fever typically ends abruptly on the third or fourth day.

With the ending of the fever comes the development of a rash. The rash is usually localized to the arms, neck, and torso. It begins as red dots and progresses into a fine rash that does not itch. After one or two days, the rash should spontaneously disappear.

There are no antibiotics or other medications to combat the virus itself. Treatment is symptomatic. Acetaminophen or ibuprofen may be recommended to bring down the fever. Aspirin should not be given to babies, children, or teenagers because a serious condition called Reye's syndrome may result. It is very important to keep the baby hydrated. Sponge baths may also be suggested by the baby's pediatrician.

Generally, exanthema subitum will go away by itself after six or seven days. The doctor should be notified if the rash worsens, if the baby cannot tolerate the symptoms, or there are signs of infection. If the illness is not progressing along the expected course, the doctor should also be informed. In most instances, the baby will recover from exanthema subitum without any adverse results.


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