Roseola overview

Jump to: navigation, search

Roseola Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Roseola from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Roseola overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Roseola overview

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Roseola overview

CDC on Roseola overview

Roseola overview in the news

Blogs on Roseola overview

Directions to Hospitals Treating Type chapter name here

Risk calculators and risk factors for Roseola overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

Roseola is a disease of infants. It is characterized by an abrupt rise in body temperature to as high as 40°C (104°F) followed by a rapid drop to normal within the next 2–4 days which coincides with the appearance of an erythematous maculopapular skin rash that persists for 1–3 days. It is typically a benign disease which resolves without sequelae. Roseola disease is caused by Human herpes virus 6 (HHV6). HHV-6A and HHV-6B are two distinct species of HHV-6.

Historical perspective

For the first time, Zahorsky of St. Louis in 1910 described a febrile exanthem occurring in infants which he termed roseola. Human herpes virus 6 was first identified in 1986.

Classification

There is no established classification system for roseola.

Pathophysiology

Roseola has two phases, the febrile and the rash (maculopapular) phase. During the first phase, HHV6 replicates in salivary glands and is secreted as primary source of infection. After complete resolution of the febrile phase, due to the latency of the virus in the lymphocytes and monocytes, the rash phase begins. A more serious form of HHV 6 is seen in older children, immunocompromised adults and organ transplant patients.

Causes

Roseola is caused by Human herpes virus 6, a member of the Herpesvirales order, Herpesviridae family, Betaherpesvirinae subfamily, and Roseolovirus genus. Herpesviruses have a unique four-layered structure: a core containing the large, double-stranded DNA genome is enclosed by an icosapentahedral capsid which is composed of capsomers. The capsid is surrounded by an amorphous protein coat called the tegument. It is encased in a glycoprotein-bearing lipid bilayer envelope.

Differential diagnosis

Roseola must be differentiated from other diseases that cause fever and rash, such as Rubella (german measles), Rubeola (measles), hand foot and mouth disease caused by coxsackie virus, erythema infectiosum caused by parvovirus B19, scarlet fever and even drug allergy.

Epidemiology and demographics

There is no accurate data for the prevalence or incidence of roseola. This is because the disease is a self limiting disease and it is under reported in most cases. Roseola is an illness of young children, with a peak prevalence between 7 and 13 months. Ninety percent of cases occur in children younger than two years. Roseola occurs equally in boys and girls. It occurs throughout the year, although outbreaks may occur in groups according to season 

Risk factors

The common risk factors in the development of roseola includes infancy (younger 2 years), immunosuppression, and organ transplantation.

Screening

According to the USPSTF, there is insufficient evidence to recommend routine screening for roseola.

Natural history complications and prognosis

The symptoms of roseola usually starts in the first 2 years of life of an infant. If roseola, left untreated, it will resolve by itself. In rare cases, febrile seizures, encephalitis, aseptic meningitis, thrombocytopenic purpura, bone marrow failure and pneumonitis. The overall prognosis of roseola is very good.

Diagnosis

History and Symptoms

The hallmark of roseola is a non pruritic macular or maculopapular rash. A positive history of a high fever of 40ºC (104ºF) that lasts for 3 to 5 days.

Physical Examination

Physical examination findings in a patient with roseola will depend on the presenting phase (febrile or rash). Vital signs are affected in the febrile phase and stabilize in the rash phase. Conversely, in the rash phase, vital signs become normal while skin appearance is affected.

Laboratory Findings

The diagnosis of roseola is made clinically. However, in atypical cases, the diagnosis can be made by both serologic and direct detection of HHV6 virus in the saliva of the patient. Expected results of diagnostic studies include antigen detection, PCR, and immunofluorescence.

Electrocardiogram

There are no electrocardiogram findings associated with roseola.

Chest X Ray

There are no chest x ray findings associated with roseola.

MRI

There are no MRI findings associated with roseola.

Echocardiography or ultrasound

There are no echocardiography or ultrasound findings associated with roseola.

Other imaging findings

There are no other imaging findings associated with roseola.

Other diagnostic studies

There are no other diagnostic studies associated with roseola.

Treatment

Medical therapy

There is no treatment for roseola; it is a self limiting disease that resolves on its own without any medical intervention but antipyretics can be used as a supportive therapy in cases of high fever.[1]

Surgery

Surgical intervention is not recommended for the management of roseola.

Primary prevention

There is no established method of prevention of roseola. However, standard sanitary procedures such as hand washing can help prevent the spread of the HHV 6 virus.

Secondary prevention

There are no secondary preventive measures available for roseola.

References


Linked-in.jpg