Rash - Paediatrics

Question 1

A 9 month old girl has a widespread rash. Her mother reports her having 2 days of fevers where she was very unsettled and lethargic. Then in the last two days a rash has spread from her neck to her torso and upper limbs. It is erythematous, maculopapular and not pruritic. A multi-systems examination is normal. Her mother does not report any fevers today and she is afebrile with normal observations when assessed.

What is the the diagnosis?

Answer 1

This girl has roseola infantum (6th disease), caused by HHV6. It is generally a benign illness characterised by several days of high temperatures followed by a widespread rash that starts on the torso/neck. These children tend to be well and do not require intervention

Question 2

Roseola Infantum

Answer 2

Aetiology

Human herpes virus 6 is the pathogen responsible for roseola.

Presentation

Children are initially febrile and lethargic for up to 5 days. Fevers can be as high as 40 degrees celcius.
Subsequently, as the fever subsites a blanching, rose-pink macular rash erupts and typically covers the trunk. It can also spread to the face and limbs.
Diagnosis

The diagnosis of roseola is made clinically
Management

Management of roseola is supportive