Roseola physical examination: Difference between revisions

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==Overview==
==Overview==
Patients are usually well appearing depending on the time of presentation, patient may present in the febrile or rash phase, in distress or not.
Physical examination findings in a patient with roseola will depend on the presenting phase (febrile or rash). Vital signs are affected in the febrile phase and stabilize in the rash phase. Conversely, in the rash phase, vital signs become normal while skin appearance is affected.


==Physical examination==
==Physical Examination==


===Appearance of the patient===
===Appearance of the patient===
Patients are usually well appearing depending on the time of presentation, patient may present in the febrile or rash phase, in distress or not.<ref name="pmid13958107">{{cite journal| author=JURETIC M| title=Exanthema subitum a review of 243 cases. | journal=Helv Paediatr Acta | year= 1963 | volume= 18 | issue=  | pages= 80-95 | pmid=13958107 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13958107  }} </ref><ref name="pmid2647267">{{cite journal| author=Meade RH| title=Exanthem subitum (roseola infantum). | journal=Clin Dermatol | year= 1989 | volume= 7 | issue= 1 | pages= 92-6 | pmid=2647267 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2647267  }} </ref><ref name="pmid8265302">{{cite journal| author=Asano Y, Yoshikawa T, Suga S, Kobayashi I, Nakashima T, Yazaki T et al.| title=Clinical features of infants with primary human herpesvirus 6 infection (exanthem subitum, roseola infantum). | journal=Pediatrics | year= 1994 | volume= 93 | issue= 1 | pages= 104-8 | pmid=8265302 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265302  }} </ref>
Physical examination findings in a patient with roseola will depend on the presenting phase (febrile or rash). Vital signs are affected in the febrile phase and stabilize in the rash phase. Conversely, in the rash phase, vital signs become normal while skin appearance is affected.<ref name="pmid13958107">{{cite journal| author=JURETIC M| title=Exanthema subitum a review of 243 cases. | journal=Helv Paediatr Acta | year= 1963 | volume= 18 | issue=  | pages= 80-95 | pmid=13958107 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13958107  }} </ref><ref name="pmid2647267">{{cite journal| author=Meade RH| title=Exanthem subitum (roseola infantum). | journal=Clin Dermatol | year= 1989 | volume= 7 | issue= 1 | pages= 92-6 | pmid=2647267 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2647267  }} </ref><ref name="pmid8265302">{{cite journal| author=Asano Y, Yoshikawa T, Suga S, Kobayashi I, Nakashima T, Yazaki T et al.| title=Clinical features of infants with primary human herpesvirus 6 infection (exanthem subitum, roseola infantum). | journal=Pediatrics | year= 1994 | volume= 93 | issue= 1 | pages= 104-8 | pmid=8265302 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265302  }} </ref>


===Vital signs===
===Vital signs===
Line 21: Line 21:
|
|
* Fever 40ºC (104ºF)
* Fever 40ºC (104ºF)
* Tachycardia
* [[Tachycardia]]
* Tachypnea
* [[Tachypnea]]
|None
|None
|-
|-
|Rash phase
|Rash phase
|Within normal limits
|Within normal limits
|Maculopapular rash
|[[Maculopapular rash]]
|}
|}


===Skin===
===Skin===
*Blanching, non-pruritic macular or [[maculopapular]] rash starting on the neck and trunks and extending towards face and extremities.
*Blanching, non-pruritic macular or [[maculopapular]] rash starting on the neck and trunks and extending towards face and extremities.
*Rash is sometimes vesicular.
*[[Rash]] is sometimes [[vesicular]].
*Rash can last anywhere from a few hours to a 3 days.<ref name="pmid13958107">{{cite journal| author=JURETIC M| title=Exanthema subitum a review of 243 cases. | journal=Helv Paediatr Acta | year= 1963 | volume= 18 | issue=  | pages= 80-95 | pmid=13958107 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13958107  }} </ref>
*[[Rash]] can last anywhere from a few hours to a 3 days.<ref name="pmid13958107">{{cite journal| author=JURETIC M| title=Exanthema subitum a review of 243 cases. | journal=Helv Paediatr Acta | year= 1963 | volume= 18 | issue=  | pages= 80-95 | pmid=13958107 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13958107 }} </ref><ref name="pmid13958107">{{cite journal| author=JURETIC M| title=Exanthema subitum a review of 243 cases. | journal=Helv Paediatr Acta | year= 1963 | volume= 18 | issue=  | pages= 80-95 | pmid=13958107 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13958107  }} </ref><ref name="pmid2647267">{{cite journal| author=Meade RH| title=Exanthem subitum (roseola infantum). | journal=Clin Dermatol | year= 1989 | volume= 7 | issue= 1 | pages= 92-6 | pmid=2647267 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2647267  }} </ref><ref name="pmid13799552">{{cite journal| author=BERLINER BC| title=A physical sign useful in diagnosis of roseola infantum before the rash. | journal=Pediatrics | year= 1960 | volume= 25 | issue=  | pages= 1034 | pmid=13799552 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13799552  }} </ref><ref name="pmid23190314">{{cite journal| author=Huang CT, Lin LH| title=Differentiating roseola infantum with pyuria from urinary tract infection. | journal=Pediatr Int | year= 2013 | volume= 55 | issue= 2 | pages= 214-8 | pmid=23190314 | doi=10.1111/ped.12015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23190314 }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Neurology]]
[[Category:Pediatrics]]
[[Category:Dermatology]]

Latest revision as of 00:03, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

Physical examination findings in a patient with roseola will depend on the presenting phase (febrile or rash). Vital signs are affected in the febrile phase and stabilize in the rash phase. Conversely, in the rash phase, vital signs become normal while skin appearance is affected.

Physical Examination

Appearance of the patient

Physical examination findings in a patient with roseola will depend on the presenting phase (febrile or rash). Vital signs are affected in the febrile phase and stabilize in the rash phase. Conversely, in the rash phase, vital signs become normal while skin appearance is affected.[1][2][3]

Vital signs

Vital signs Skin manifestations
Febrile phase None
Rash phase Within normal limits Maculopapular rash

Skin

  • Blanching, non-pruritic macular or maculopapular rash starting on the neck and trunks and extending towards face and extremities.
  • Rash is sometimes vesicular.
  • Rash can last anywhere from a few hours to a 3 days.[1][1][2][4][5]

References

  1. 1.0 1.1 1.2 JURETIC M (1963). "Exanthema subitum a review of 243 cases". Helv Paediatr Acta. 18: 80–95. PMID 13958107.
  2. 2.0 2.1 Meade RH (1989). "Exanthem subitum (roseola infantum)". Clin Dermatol. 7 (1): 92–6. PMID 2647267.
  3. Asano Y, Yoshikawa T, Suga S, Kobayashi I, Nakashima T, Yazaki T; et al. (1994). "Clinical features of infants with primary human herpesvirus 6 infection (exanthem subitum, roseola infantum)". Pediatrics. 93 (1): 104–8. PMID 8265302.
  4. BERLINER BC (1960). "A physical sign useful in diagnosis of roseola infantum before the rash". Pediatrics. 25: 1034. PMID 13799552.
  5. Huang CT, Lin LH (2013). "Differentiating roseola infantum with pyuria from urinary tract infection". Pediatr Int. 55 (2): 214–8. doi:10.1111/ped.12015. PMID 23190314.