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Roseola Infantum — RACP Paediatrics MCQ

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EasyInfectious DiseaseRoseola InfantumRACP Paediatrics

A 2-year-old girl presents with a 2-day history of high fever (40°C), who suddenly develops a widespread maculopapular rash as the fever subsides. She is well-appearing and the rash is non-pruritic. What is the most likely diagnosis?

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Correct answer: A — Roseola infantum (HHV-6)

Roseola infantum (exanthem subitum), caused by human herpesvirus 6 (HHV-6), classically presents with 3–5 days of high fever followed by the appearance of a maculopapular rash as the fever resolves ('fever and then rash'). The child typically appears well once the rash appears. In measles, the rash appears while the child is still febrile and unwell.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Viral Exanthems