Rashes Following a Fever in Children

If your child’s illness has passed and then a rash appears, this can be cause for concern among most parents. Roseola and fifth disease are common childhood illnesses that first cause a fever that’s followed by a rash 2. Always consult with your child’s doctor for a proper diagnosis and treatment.


Roseola causes a high fever with a quick onset that’s often more than 103 degrees Fahrenheit. Your child will have a runny nose, mild sore throat and red puffy eyes. The fever disappears and then a non-itchy rash of small pink spots develops on your child’s chest, stomach and back before spreading to the extremities. Your child may also have swollen lymph nodes of the neck. Fifth disease has a mild fever with cold-like symptoms that include a runny nose, congestion and cough 2. Once the fever disappears, a rash develops on your child’s face that looks like he was slapped on the cheeks. The rash spreads to your child’s trunk and extremities a few days later. If your child has fifth disease, he does not usually feel ill once the rash is present 2.


Roseola is most commonly caused by the human herpesvirus 6, but is sometimes caused by human herpesvirus 7. Fifth disease is caused by parvovirus B16 2. Fifth disease and roseola are contagious and are transmitted by an infected person’s respiratory secretions or saliva, but the illnesses can also be spread by fecal-to-oral transmission 2. These illnesses are easily spread in daycare settings because of frequent diaper changing and because children are less likely to cover a sneeze or wash their hands after using the bathroom. Once the rash is present for both roseola and fifth disease, the illnesses are less contagious 2.


Since both are viruses, there is little that can be done to treat the conditions other than making your child comfortable. The high fever from roseola is reduced with acetaminophen or ibuprofen. Since the fever for fifth disease is fairly low-grade, an over-the-counter fever reducer is rarely necessary unless the fever is bothersome or more than 102 degrees Fahrenheit 2. A cool sponge bath provides relief to a child with a high fever. Doctors often give the anti-viral medication ganciclovir to treat roseola in children with weak immune systems. Most children recover within a week from both roseola and fifth disease 2.


There is no vaccination for roseola or fifth disease 2. If your child is sick, keep him home from school or daycare. Encourage your child to wash his hands frequently, especially after using the restroom, playing with other children or before eating. Encourage your child's school to disinfect regularly touched surfaces with diluted bleach to kill viruses.