Three-day fever, which is synonymously called exanthema subitum, Roseola infantum or older the sixth disease, is one of the classic childhood diseases of the first two years of life. Almost all children in the third year of life have had the disease or at least carry the pathogen within themselves. The disease can be recognized by the typical rash on the skin.
Causes
Three-day fever is an acute illness of the baby and is caused by a virus, the HHV-6, occasionally HHV-7, which belongs to the group of herpes viruses. Typical of herpes viruses is the characteristic that they remain inactive in the body of a healthy person after the illness. Thus, transmission to babies by healthy adults or children occurs via saliva or so-called droplet infections, such as when sneezing.
How does a rash develop?
A rash on the skin, medically exanthema, occurs in many different diseases and can have different dimensions, causes and meanings. It is to be seen as a reaction to external or internal stimuli, which is allergic or inflammatory. A rash has several forms.
In addition to the redness, blisters, pustules, wheals or scaling can also occur. A frequent symptom is a pronounced itching. The spread on the body varies greatly.
Small circumscribed skin areas can be affected or the entire body surface. The redness of the skin also depends on the cause of the rash. Spotty spots or extensive redness with all the facets in between are conceivable. Thus a rash can often be assigned to the causative disease.
What is the rash in three-day fever?
The rash that occurs in three-day fever is typical and one of the most important diagnostic criteria. It appears after the fever has subsided. A typical feature of the rash is its rapid development, so that the baby shows clear changes within hours.
Initially red, small areas of redness appear on the breast, abdomen and neck. These can become larger and partly merge into each other, which is called confluent in technical language. In some cases the rash then spreads further to the arms and legs.
At the peak of the rash, which also disappears quickly after 2-3 days, almost the entire body may be covered with red spots. Appearances on the face are rather rare. Itching does not usually occur with three-day fever.
In some places, one can feel minimal elevations, i.e. bulges of the skin that can be felt with the finger above the rash. The rash in three-day fever is typically emphasized on the trunk of the body. However, it can also spread to the neck and from there to the head.
Since the rash on the head is not a typical localization in three-day fever, further differential diagnoses must be considered. Since children up to the age of 3 are particularly affected by the three-day fever, the rash must be distinguished from simple milk crust or other childhood diseases such as measles or chickenpox. The rash of the three-day fever usually spreads mainly to the neck, abdomen and chest area and, as the illness progresses, to the extremities, i.e. arms and legs, and the back.
It is rarely found on the face. Nevertheless, there are always children in whom the rash is not limited to the rest of the body. If the rash is on the face, one can only hope that at least it does not itch, otherwise scars can easily remain when scratching.
In rare cases, the rash from the three-day fever can also spread to the arms and legs. Since this is not a typical localization, some of them have to be excluded, including other serious clinical pictures. First of all, other children’s diseases that more frequently cause a rash on the legs, such as measles, rubella, rubella ring or chickenpox, come into consideration.
The extensor sides of the legs also represent a typical localization of a purpura Schönlein-Henoch, which means the smallest capillary bleeding in the skin. It usually occurs after an infection of the upper respiratory tract. A very serious clinical picture in which purpura and punctiform bleeding (petechiae) can also occur is the Waterhouse-Friderichsen syndrome in the course of a bacterial meningitis.
Normally, the rash of the three-day fever is not accompanied by itching. However, children often complain that the reddish rash itches. The rash is also raised.This means that you can feel it when you stroke it with your hand or your finger.
Often the small children then start to scratch themselves and sometimes even scars can remain. There are creams and tinctures that can be applied to alleviate the itching. Usually herbal or homeopathic medicines are sufficient for this.
However, there are also creams such as Eucerin® or Schaebens Derma Forte Itching Cream® which fight itching well. However, you should always consult a doctor or pharmacist before giving your child a cream on your own. Normally, the rash or itching disappears as quickly as it came. This means that you often do not even manage to get appropriate creams or tinctures, because the symptoms have already disappeared again.
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