Diagnosis

Roseola can be difficult to diagnose because initial signs and symptoms are similar to those of other common childhood illnesses. If your child has a fever and it's clear that no cold, ear infection, strep throat or other common condition is present, your doctor may wait to see if the characteristic rash of roseola appears. Your doctor may tell you to look for the rash while you treat your child's fever at home.

Doctors confirm a diagnosis of roseola by the telltale rash or, in some cases, by a blood test to check for antibodies to roseola.

Treatment

Most children recover fully from roseola within a week of the onset of the fever. With your doctor's advice, you can give your child over-the-counter medications to reduce fever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.

There's no specific treatment for roseola, although some doctors may prescribe the antiviral medication ganciclovir (Cytovene) to treat the infection in people with weakened immunity. Antibiotics aren't effective in treating viral illnesses, such as roseola.

Lifestyle and home remedies

Like most viruses, roseola just needs to run its course. Once the fever subsides, your child should feel better soon. However, a fever can make your child uncomfortable. To treat your child's fever at home, your doctor may recommend:

  • Plenty of rest. Let your child rest in bed until the fever disappears.
  • Plenty of fluids. Encourage your child to drink clear fluids, such as water, ginger ale, lemon-lime soda, clear broth, or an electrolyte rehydration solution (Pedialyte, others) or sports drinks, such as Gatorade or Powerade, to prevent dehydration. Remove the gas bubbles from carbonated fluids. You can do this by letting the carbonated beverage stand or by shaking, pouring or stirring the beverage. Removing the carbonation will mean having your child avoid the added discomfort of excess burping or intestinal gas that carbonated beverages may cause.
  • Sponge baths. A lukewarm sponge bath or a cool washcloth applied to your child's head can soothe the discomfort of a fever. However, avoid using ice, cold water, fans or cold baths. These may give the child unwanted chills.

There's no specific treatment for the rash of roseola, which fades on its own in a short time.

Coping and support

Roseola will likely keep your child home for a few days. When staying home with your child, plan low-key activities that you both will enjoy. If your child is sick and you need to return to work, recruit help from your partner or from other relatives and friends.

Preparing for your appointment

Make an appointment with your child's doctor if your child has a rash that doesn't improve after a few days, or if your child has a fever that lasts more than a week or exceeds 103 F (39.4 C).

Here's some information to help you get ready for your appointment, as well as what to expect from your doctor.

Information to gather in advance

  • List your child's signs and symptoms, and note how long your child has had them.
  • Write down your child's key medical information, including other conditions for which your child has been treated and any prescription or over-the-counter medications your child has taken recently.
  • List any possible sources of infection, such as other children who've recently had a high fever or a rash.
  • Write down questions to ask your doctor. Creating your list of questions before your child's appointment can help you make the most of your time with your doctor.

Below are some basic questions to ask your doctor about roseola. If any additional questions occur to you during your visit, don't hesitate to ask.

  • What is the most likely cause of my child's signs and symptoms?
  • Are there other possible causes?
  • Should I treat my child's fever?
  • What over-the-counter fever medications are safe for my child, if any?
  • What else can I do to help my child recover?
  • How soon do you expect my child's symptoms to improve?
  • Is my child contagious? For how long?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • What are your child's signs and symptoms?
  • When did you notice these signs and symptoms?
  • Have your child's signs and symptoms gotten better or worse over time?
  • Have any children with whom your child interacts had a recent high fever or a rash?
  • Has your child had a fever? How high?
  • Has your child had diarrhea?
  • Has your child continued to eat and drink?
  • Have you tried any at-home treatments? Has anything helped?
  • Has your baby recently had any other medical conditions?
  • Has your baby recently taken any new medications?
  • Is your child in child care?
  • What else concerns you?

What you can do in the meantime

Before your appointment, encourage your child to rest and drink fluids. You may be able to ease fever-related discomfort with a lukewarm sponge bath or cool compresses. Ask your doctor whether over-the-counter fever medications are safe for your child.

May 28, 2015
References
  1. Tremblay C, et al. Roseola infantum (exanthem subitum). http://www.uptodate.com/home. Accessed April 8, 2015.
  2. Tremblay C, et al. Human herpes virus 6 infection in children: Clinical manifestations; diagnosis; and treatment. http://www.uptodate.com/home. Accessed April 8, 2015.
  3. Mamishi S, et al. Prevalence of HHV-6 in cerebrospinal fluid of children younger than 2 years of age with febrile convulsion. Iranian Journal of Microbiology. 2014;6(2):87. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281666/. Accessed April 8, 2015.
  4. Roseola infantum. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/pediatrics/miscellaneous_viral_infections_in_infants_and_children/roseola_infantum.html?qt=human herpesvirus 6&alt=sh. Accessed April 8, 2015.
  5. NINDS Reye's syndrome information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm. Accessed April 8, 2015.
  6. What is the role of aspirin in triggering Reye's? National Reye's Syndrome Foundation. http://www.reyessyndrome.org/aspirin.html. Accessed April 8, 2015.