A viral illness most commonly seen in children younger than two years of age. It is characterized by an average of three to five days of high fever-ranging from103°F to 105°F and occasionally as high as 106°F-ac-companied by very few specific symptoms. A mild runny nose, an occasional cough, a little drowsiness, and at times irritability may be noted, but overall the child with roseola does not appear as ill as the temperature might lead you to expect. (In fact, a child may seem to be in surprisingly good spirits.) After the temperature abruptly returns to normal, a rash appears. Fine red spots or bumps first appear on the upper body and then spread to the upper arms and neck, with little involvement of the face and legs. The rash fades quickly. If your child experiences a high fever for more than24 hours, check with his physician, who may want to evaluate him. Typically there will be no findings from examination or laboratory tests (such as a blood count or urinalysis) to suggest a specific treatable cause of the fever. Supportive measures such as acetaminophen (Tylenol) to reduce fever, extra fluids, and light clothing are the only necessary treatment. Since roseola is caused by a virus, antibiotics will not affect its course. The illness is contagious until the fever has disappeared. Roseola is not considered dangerous, although the high fevers it often generates can be worrisome to parents. Remember that, with very rare exception, the main purpose of cooling measures is to keep the child comfortable. If he is responsive and appears relatively con-tent, the fever can belch to run its course.
In some children with roseola, a rapid upswing of temperature may provoke a febrile seizure. This will re-quire consultation with the child’s physician to rule out a more serious illness. Aggressive cooling measures for a child who already has a high fever will do little to prevent febrile seizures.