There are many reasons that can lead to the appearance of a rash on the skin. While some of these reasons are not serious, others might prove out to be life-threatening. One of the cases when you need to take things seriously is if your child has had a fever outbreak, followed by a rash. This condition is known as roseola, being primarily characterized by the extended body rash that appears after fever. Small children – between the ages of 6 months and 2 years – present the highest risks of developing this condition. Proper monitoring and treatment are required for the rash after fever.
Also known as exanthematous fever or the three-day rash, this condition is easily transmitted from one child to the other (highly contagious). The rash appearing after the fever outbreak is distinctive for the viral condition. It is important to understand that, while small children are highly susceptible, it can also affect adults in rare cases. It is one of the most common viral infections encountered in children, most children being infected before they reach 3 years of age. One needs to keep a careful watch over the progression of the condition, so as to avoid potential complications.
Symptoms of Rash after Fever
- High-running ( over 39.5 degrees Celsius)
- Lasts between 3 and 5 days (hence the name)
- Lymph nodes are swollen
- Coughing accompanies the fever
- Before the appearance of the fever:
- Runny nose
- Sore throat (not severe)
- Appears after the fever outbreak
- Patches/pink spots on the entire body – initial stage
- Raised + white ring around them
- Uniform + plat
- May start at the chest, abdomen or back
- Extends to the limbs
- In many situations – rash does not appear on the face/legs
- Rash can last from a couple of hours to several days (gradually fading)
- Does not cause discomfort/itchiness
- Easy irritable
- No appetite
- Eyelids are inflamed
High fever leads to seizures or convulsions
- Requires immediate medical attention – emergency
- Febrile seizures – 10-15% of young children
- During the seizure, the following things can occur:
- Loss of consciousness
- Limb jerking/muscle twitching
- Loss of bladder or bowel control.
Causes of Rash after Fever
These are the causes that lead to the appearance of a rash after fever:
Herpetic viruses – human herpesvirus 6 and 7
- Transmission – saliva
- Not necessary for the rash to be present, for the condition to be contagious
- Rare cases – community outbreak
- Infants – highest risk for roseola (immunity system insufficiently developed)
Low immunity – this is more of a risk factor than a cause
- Compromised immunity will make the child more prone to complications (febrile seizures); these can lead to brain damage, if they are not immediately treated.
Age – older infants present a higher risk of developing this condition. Those who have been recently born still have the antibodies from the mother to protect them.
The following treatment courses can be undertaken for this condition:
Symptomatic medication – reduce the fever
- Aspirin is not recommended in children for fever reduction, as it can lead to other health problems
Anti-viral medication – promotes faster healing by eliminating the infectious organism
- Recommended to immunocompromised patients
- Reduces the risk of complications
- Avoid strenuous effort, provide plenty of rest for the infection to pass
- Drink plenty of fluids to maintain the body hydrated
- Chicken broth
- Electrolyte solution
- Sponge bath
- Reduces the fever
- Use lukewarm water or a cold washcloth
- Refrain from using ice or cold water, as this can have serious consequences, leading to chills
- Breast milk
- As this condition occurs in small children, breast milk can help them stay hydrated and get antibodies to fight off the infection.
At the moment, there is no vaccine that can be administered in order to prevent the rash after the fever. This is the reason why the best prevention method is actually avoiding getting in contact with a person who has already been infected. Infected children should not be brought into the daycare or to the kindergarten, as this infection is easily transmissible and a community outbreak will occur. Inside the house, excellent hygiene measure should be taken, in order to avoid the passing of the infection from one person to the other. Washing hands frequently with soap, using clean towels and not sharing objects of personal hygiene (including towels) – all of these represent recommendations that should be followed in order to prevent the spreading of the infection in a household.
It is important to understand that roseola is easily transmitted, not only by personal contact but also by sneezing, coughing or even talking. The condition is most often transmitted in the period when there are no symptoms present, so prevention is essential to reduce the number of people infected. Once a person or a child is diagnosed with roseola, it is said that antibodies are built to resist to future infections. However, there were cases in the medical literature when the rash after fever re-occurred. These cases are not common, as most children develop the antibodies they need to be protected from the re-occurrence, being infected at an early age.
If you take your child to daycare or kindergarten, then make sure you verify if the standard hygiene measures are respected. Toys should be decontaminated on a regular basis and children should be checked for fever, so as to prevent a community outbreak. If your own child has been infected, then refrain from bringing him/her into a community. Also, keep in mind that the infection is self-limiting, so it will disappear on its own within a couple of days.
The best prevention is by avoiding contact with people or children who are acutely ill (high running fever) and also by following the recommended hygiene measures.