Roseola: Why It Can Occur After Age Two

Roseola only appeared after the age of two?

Hello, doctor~~~ My son is currently almost 2 years and 2 months old.
A few days ago, he had a fever, and after the fever subsided, he developed a large rash.
We took him to see a doctor, who said it was roseola.
However, isn't roseola typically seen in children under 2 years old? Why is my son, who is already over 2 years old, experiencing it now? (He hasn't had it before.) Will it be harder for him to recover? Thank you, doctor! ^^

Xiao Yu Er, 20~29 year old female. Ask Date: 2007/03/03

Dr. Chen Rongtai reply Pediatrics

Hello, Little Fish's Mom.
Roseola is a viral infection primarily caused by human herpesvirus types 6 and 7.
It is a benign illness with very few complications or sequelae.
Although it is most commonly seen in children aged six months to one and a half years, it can also occur in infants as young as two or three months and in children as old as two or three years.
Roseola is a common benign infectious disease in young children.
It typically presents with a high fever, which can reach temperatures of 39 to 40 degrees Celsius, usually lasting for three to four days.
During the fever, aside from the cheeks appearing flushed, the child's appetite and activity levels generally remain good, and there may be mild symptoms of upper respiratory infection such as a slight cough or runny nose, with no significant findings upon examination.
The hallmark of this illness is that when the characteristic rose-colored maculopapular rash appears, it often coincides with the resolution of the fever, signaling that the illness is nearing its end.
Occasionally, due to individual susceptibility, high fever may lead to febrile seizures, but there is no need for alarm as these are typically benign.
-- Nantou Hospital wishes you good health and all the best.

Reply Date: 2007/03/03

More Info

Roseola, also known as roseola infantum or sixth disease, is a viral infection typically caused by human herpesvirus 6 (HHV-6) and, less commonly, human herpesvirus 7 (HHV-7). It is most commonly seen in children between the ages of 6 months and 2 years. However, it can occur in older children, including those over the age of two, as you have experienced with your son.

The reason your son, who is now 2 years and a couple of months old, developed roseola is that while the infection is most prevalent in younger children, it is not exclusive to them. The immune system of children can vary significantly, and some children may not have been exposed to the virus earlier in life. As a result, they can develop roseola even after the typical age range.
When a child experiences a sudden high fever, often lasting for three to five days, followed by a rapid drop in temperature and the appearance of a rash, it is indicative of roseola. The rash usually appears as small, pink spots that may start on the trunk and spread to the limbs. It is important to note that the rash itself is not contagious; rather, the virus is spread through respiratory secretions, such as saliva, from an infected person.

As for the concern regarding the duration of the illness, roseola is generally self-limiting and resolves on its own within a week. Most children recover completely without any complications. However, the duration and severity of symptoms can vary from child to child. In older children, the immune response may be different, but this does not necessarily mean that the illness will be more severe or take longer to resolve.
If your son has developed roseola, it is essential to monitor his symptoms. Ensure he stays hydrated and comfortable, and use fever-reducing medications if necessary, as advised by your healthcare provider. If he experiences any concerning symptoms, such as difficulty breathing, persistent high fever, or if the rash appears to worsen, it is crucial to seek medical attention promptly.

In summary, while roseola is most common in younger children, it can occur in older children as well, especially if they have not been previously exposed to the virus. The prognosis is generally good, and most children recover without complications. If you have any further concerns about your son's health or the rash, do not hesitate to consult with your pediatrician for personalized advice and care.

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