Case history
Case history
A previously healthy 9-month-old infant presents with a 4-day history of irritability and high fever in the range of 39°C to 40°C (102°F to 104°F), peaking in the early evening. On day 4 of illness his fever and irritability resolved, and he then developed a rash consisting of 2- to 5-mm red macules on his trunk that spread to his proximal extremities. The rash faded over a day and he has remained well.
Other presentations
Febrile seizures occur in 10% to 15% of infants with roseola. Other findings include a bulging anterior fontanelle; oropharyngeal inflammation and ulcers; mild posterior cervical, post-auricular, or occipital lymphadenopathy; tympanic inflammation; cough; rhinorrhoea; and mild diarrhoea. Encephalitis can occur, but very rarely. Some polymerase chain reaction viral panels have become available for testing cerebrospinal fluid samples of patients with encephalitis. These panels frequently include HHV-6. In the authors' experience, they have occasionally found HHV-6 positives in infants with very mild encephalitis and, on one occasion, severe encephalitis.
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