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Roseola Infantum Treatment & Management

  • Author: Christopher R Gorman, MD; Chief Editor: William D James, MD  more...
 
Updated: Jun 02, 2016
 

Medical Care

At present, no medical antiviral therapy is available for human herpesvirus 6 (HHV-6) infection that causes roseola. Thus, treatment of roseola infantum is supportive.[11] However, in 2002, Rapaport et al reported that antiviral prophylaxis with ganciclovir may prevent HHV-6 reactivation in high-risk bone marrow transplant patients.[12] Further double-blinded randomized studies are needed.

Short- or long-term antiseizure medications are not recommended for infants who have had a febrile seizure secondary to roseola.

Inpatient care for roseola infantum consists of support with antipyretics and treatment of gastroenterologic, respiratory, hematologic, or CNS complications.

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Consultations

A pediatric consultation is recommended for infants with roseola infantum who have febrile seizures.

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Complications

In roseola infantum, complications are rare. Given that seroconversion is practically universal, finding any of the complications that have been reported in the gastrointestinal, central nervous, pulmonary, and hematopoietic systems is rare.

Children who have seizures with roseola are not expected to have further febrile or nonfebrile seizures.

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Prevention

Because seroconversion in the United States is nearly 100%, isolation is not indicated. The infection is spread through saliva in both the acute phase and the chronic phase.

No risk appears to be present to pregnant women exposed to roseola. Care must be taken to distinguish this from rubella. No reports of infection or complications following exposure exist. This is probably because of the nearly universal seroconversion and latent infection. No sequelae of intrauterine infection are known. Isolation is not indicated.

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Contributor Information and Disclosures
Author

Christopher R Gorman, MD Avenues Dermatology, Private Practice

Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Franklin Flowers, MD Department of Dermatology, Professor Emeritus Affiliate Associate Professor of Pathology, University of Florida College of Medicine

Franklin Flowers, MD is a member of the following medical societies: American College of Mohs Surgery

Disclosure: Nothing to disclose.

Acknowledgements

Acknowledgments

Medscape Drugs & Diseases wishes to recognize Stephen W White, MD† for his original contributions to this article.

References
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  2. Abdel Massih RC, Razonable RR. Human herpesvirus 6 infections after liver transplantation. World J Gastroenterol. 2009 Jun 7. 15(21):2561-9. [Medline]. [Full Text].

  3. Kittaka S, Hasegawa S, Ito Y, Ohbuchi N, Suzuki E, Kawano S, et al. Serum levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 in human herpesvirus-6-infected infants with or without febrile seizures. J Infect Chemother. 2014 Nov. 20 (11):716-21. [Medline].

  4. Zerr DM, Meier AS, Selke SS, et al. A population-based study of primary human herpesvirus 6 infection. N Engl J Med. 2005 Feb 24. 352(8):768-76. [Medline].

  5. Vianna RA, de Oliveira SA, Camacho LA, et al. Role of human herpesvirus 6 infection in young Brazilian children with rash illnesses. Pediatr Infect Dis J. 2008 Jun. 27(6):533-7. [Medline].

  6. Magalhães Ide M, Martins RV, Vianna RO, Moysés N, Afonso LA, Oliveira SA, et al. Detection of human herpesvirus 7 infection in young children presenting with exanthema subitum. Mem Inst Oswaldo Cruz. 2011 May. 106(3):371-3. [Medline].

  7. Razonable RR, Lautenschlager I. Impact of human herpes virus 6 in liver transplantation. World J Hepatol. 2010 Sep 27. 2(9):345-53. [Medline]. [Full Text].

  8. Ward KN. The natural history and laboratory diagnosis of human herpesviruses-6 and -7 infections in the immunocompetent. J Clin Virol. 2005 Mar. 32(3):183-93. [Medline].

  9. Ward KN, Andrews NJ, Verity CM, Miller E, Ross EM. Human herpesviruses-6 and -7 each cause significant neurological morbidity in Britain and Ireland. Arch Dis Child. 2005 Jun. 90(6):619-23. [Medline].

  10. Higashimoto Y, Ohta A, Nishiyama Y, et al. Development of a human herpesvirus 6 species-specific immunoblotting assay. J Clin Microbiol. 2012 Apr. 50(4):1245-51. [Medline]. [Full Text].

  11. Stone RC, Micali GA, Schwartz RA. Roseola infantum and its causal human herpesviruses. Int J Dermatol. 2014 Apr. 53(4):397-403. [Medline].

  12. Rapaport D, Engelhard D, Tagger G, Or R, Frenkel N. Antiviral prophylaxis may prevent human herpesvirus-6 reactivation in bone marrow transplant recipients. Transpl Infect Dis. 2002 Mar. 4(1):10-6. [Medline].

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Roseola infantum. Image courtesy of Wikimedia Commons.
Roseola infantum. Image courtesy of Wikimedia Commons.
 
 
 
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