Approach

Roseola is usually diagnosed based on the classic presentation of a previously healthy infant, 6 to 24 months of age, with a sudden onset of high fever for 3 to 4 days. Resolution of fever is associated with the onset of discrete red macules and papules on the trunk and extremities. For patients with this classic presentation, a clinical diagnosis can be made based on physical examination findings and history (usually at the time of loss of fever). Diarrhoea and upper respiratory symptoms are also reported, though not diagnostic. Laboratory investigation is seldom necessary. An FBC may initially show an elevated WBC, which may evolve into a low WBC with relative neutropenia and atypical lymphocytosis.[9] There may be sterile pyuria in some infants with roseola.[12]

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