Rashes After Fever In Toddlers: Causes & Tips To Manage It

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Fever and skin rashes can be present in many infectious diseases, and it is more common in children than adults. Despite the rashes, a toddler may appear well. These rashes can be due to immune reactions of the body towards the virus or other pathogen. A skin rash during fever can be more serious than a rash developing after fever. Sometimes bleeding spots may be confused with rashes.

Read this post to learn about the various infectious diseases that cause skin rashes in toddlers after a fever.

Causes Of Rashes After Fever In Toddlers

Dr. Loretta Cody, a board-certified pediatrician from New York City Metropolitan Area, says, “Many viral illnesses in children can be associated with a rash. This is called a viral exanthem. Some of the common viral illnesses associated with a rash in toddlers are coxsackie, chickenpox, erythema infectiosum also known as Fifth disease, and roseola. The viral rashes can appear from red bumps and blotches to itchy fluid-filled blisters as seen with chickenpox. Many viruses associated with a rash are diagnosed by the appearance of the rash.”

The following conditions may cause rashes in toddlers after a fever.

1. Roseola

Roseolainfantum, also called the sixth disease, three-day fever, exanthemsubitum, or pseudo-rubella, is common in toddlers. This is caused by human herpesvirus-6 (HHV-6) (1). Another strain of herpes virus, herpesvirus-7, may also cause roseola in toddlers in rare cases.

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Fever in roseola: The infection may begin with a high fever, often ranging from 102°F to 105°F (38.8°C to 40.5°C) in children below two years of age. The fever may last for three to seven days and often present with the following symptoms.

• Diarrhea
• Cough
• Runny nose
• Lack of appetite

Rash in roseola: The skin rashes appear after the fever subsides, usually 12 to 24 hours after the fever. This is the difference between roseola and measles. In measles, the fever spikes as the rashes appear whereas in roseola, the appearance of rashes coincides with remission of fever. Slightly raised pink rashes on the belly, chest, and back of the body are seen in roseola. Roseola is not diagnosed until rashes appear, and most toddlers are no longer contagious 24 hours after the fever resolves. The rash may last for one to three days, and most children are fine by the time the rash appears.

Treatment for roseola: There is no specific treatment for roseola in toddlers, and the condition may run its natural course. However, it is recommended to seek pediatric care for fever spikes since it may cause febrile seizuresⁱXFits in children caused by fever in some toddlers.

An anonymous blogger who goes by the name ‘Cornyman’ shares how his toddler developed a rash after a fever. He says, “Roseola Infantum infected Timmy, and he suddenly had a very high fever after we came back shopping. During the fever, it wasn’t easy to make him sleep, and he cried very often…About two days later, the fever was gone, and the rash appeared for the first time on his head. Initially, we thought it was some bites from ants (at that time, we did not know about Roseola Infantum). But the rashes showed up more and more. It covered the neck, slowly to the chest and back, finally his arms and legs were covered (i).”

2. Hand, foot, and mouth disease (HFMD)

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Hand, foot, and mouth disease (HFMD) is a viral illness caused by viruses belonging to the enterovirusⁱXA group of viruses causing infections with symptoms such as body aches, fever, cough, skin rash, runny nose, mouth blisters, etc. family. Coxsackievirus A16, coxsackievirus A6, and enterovirus 71 (EV-A71) are common viruses associated with HFMD in toddlers. Most children may get HFMD by five years of age (2).

Fever in HFMD: This disease may begin with mild fever, sore throat, and lack of appetite in toddlers. Painful mouth sores are seen one or two days after the fever. These sores may begin as small red spots and become blisters. Fever may subside within three days in most toddlers. Eating or drinking issues due to painful swallowing and drooling are also seen in HFMD.

Rash in HFMD: Toddlers may develop red spots on the palms and soles. The itching rashes may spread to the buttocks, limbs, and genital area in severe cases. The rashes initially look like raised red spots, but later become blister like in appearance.

Treatment for HFMD: There is no specific cure for HFMD, and it may resolve within seven days after running its natural course. Children may require fever medications and hydration to prevent dehydration. Severe infection may affect fingernails or toenails, causing them to fall off. You may consult a pediatrician or pediatric dermatologist in such cases (3).

3. Fifth disease

Fifth disease, also known as erythema infectiosum or slapped cheek disease, is a mild rash-causing viral illness due to parvovirus B19. Bright red rash on the cheeks gives the name “slapped cheek disease,” and the other name, the fifth disease, comes from an order of old classifications of viral skin rash diseases in children (4).

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Fever in the fifth disease: Cold-like symptoms such as runny nose followed by mild fever is characteristic of this condition. Fever may last seven to ten days, and children are contagious during this time.

Rash in the fifth disease: Rosy cheeks may appear as “slapped cheek” or “slapped face” and are usually seen seven to ten days after fever. This rash can be slightly raised with lace-like patterns and often spread to the body and limbs. Fifth disease rash often disappear in seven to ten days. In some toddlers, the rash may come and go for several weeks in various parts of the body. Fifth disease is more a disease of the older children than toddlers.

Treatment for the fifth disease: This is a mild childhood illness that goes away without specific treatments. Healthy children may recover without complications. However, if your child has any health condition, the symptoms may worsen, requiring medical care.
Many other diseases, such as measles and scarlet fever, can cause skin rashes and fever in toddlers. However, these conditions may usually cause fever during the onset of skin rash. Although it is possible to have skin rash after seven days of illness in scarlet fever, this condition is rare in toddlers due to maternal antibodies. Also, in dengue, sometimes after the fever subsides, red, flat, non blanching rashesⁱXRashes caused by bleeding of blood vessels under the skin and do not disappear when pressed may appear which are bleeding spotsⁱXBroken blood vessels or blood collecting under skin tissue in larger areas, also known as purpura . These children should immediately be taken to their doctor.

Quick tip

If your child experiences a convulsion lasting more than five minutes and fails to regain consciousness after the episode, reach out to the local emergency care (5).

Home Management Of Skin Rashes After Fever

Most viral illnesses require time to run their course, and most toddlers feel better after the fever ends. Viral rashes after fever may not require treatment since it fades away in a short time. You may try the following home care measures during these illnesses to ease the symptoms.

• Provide hydration: Give plenty of fluids to your toddler during febrile illnesses to prevent dehydration. You may give clear fluids such as water, clear broth, diluted fruit juices, coconut water and oral rehydration solutions, to the toddler to replace water and electrolyte loss. Toddlers who breastfeed should continue to breastfeed as usual.

Image: S: iStock

• Ensure plenty of rest: Make sure your toddler is getting enough rest and sound sleep during illness since it could aid in recovery.

• Sponge baths: You may clean your toddler with a cool washcloth or lukewarm sponge bath during fever to prevent chills and discomfort due to bathing. It is better to avoid cold water, ice packs, and cold room temperature during febrile illnesses in toddlers. A lukewarm water bath may be given.

• Medications: You may give fever medications to the toddler as per the doctor’s directions. You may also consider skin medications and lotions as per the doctor’s recommendations to relieve any rash-related skin irritation in the toddler. For oral ulcers, soothing gels might be applied on a doctor’s prescription only.

• Soft and cold foods: Sore throat, mouth ulcers, and rashes around the mouth may make it difficult for a toddler to swallow and chew food. Soft food items, such as vegetable mash, or liquid-based food items, such as smoothies and soups, brought to room temperature, could be ideal options during this phase. Good nutrition during illness is important to bring the child back to his pre-illness health. Since consumption is decreased during illness, more frequent and calorie dense feeding may be given. This may be achieved by adding oil or ghee to each feed.

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While you take care of the toddler, ensure your safety. To prevent the spread of rashes and allergic reactions, washing your hands with soap and water before and after touching the child during these illnesses is vital.

Quick tip

The doctor may prescribe calamine lotion or hydrocortisone cream if necessary; however, avoid self-medication (6).

When To See A Doctor?

You may contact the pediatrician if your toddler has a fever lasting for more than three days or has a high temperature. Rashes after fever can be managed at home as per the doctor’s suggestions. However, worsening redness or rashes lasting longer than usual could require medical care. Any non-blanching rash, or any rash accompanied by other bleeding manifestations , should be immediately brought to a doctor’s notice.

Quick tip

Seek immediate medical assistance if your child exhibits purple or bright red bruises or spots that do not change color (7).

Infographic: Symptoms To Identify Diseases That Cause Fever And Rash

Several illnesses may cause fever with rashes. However, certain additional symptoms may assist in quick diagnosis. Go through the infographic below that lists such accompanying symptoms.

Illustration: Momjunction Design Team

Get the high-quality PDF version of this infographic.

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Dr. Shaon MitraMD

Dr. Shaon Mitra is a consultant pediatrician and neonatologist with 17 years of experience. She is attached to several hospitals in Kolkata, West Bengal, including Bellevue Clinic, ILS Hospitals Salt Lake, and Park View Superspeciality Hospital. Previously, she worked as an Assistant Professor in Pediatrics at KPC Medical College & Hospital. In addition to being a certified Medical Teacher under...more

• Dr. Loretta CodyMD

  Dr. Loretta Cody is a board-certified pediatrician with over 34 years of experience. She holds an MD from New York Medical College and has practiced pediatrics in Connecticut for many years. In addition to providing care to her patients, she also mentors students pursuing careers in medicine.
  
  Dr. Loretta Cody is a board-certified pediatrician with over 34 years of experience. She holds an MD from New York Medical College and has practiced pediatrics in Connecticut for many years. In addition to providing care to her patients, she also mentors students pursuing careers in medicine.

Dr Bisny T. JosephMedical Doctor

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has around 5 years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education...more

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Rohit Garoo is a writer-turned-editor with over 9 years of experience in content writing, editing, and content marketing. He did his bachelors in Science at St. Xavier's College, Hyderabad, and masters in Business Administration at Osmania University. Also, he holds a certificate in Developmental Psychology from The University of Queensland and loves to expand his knowledge through certifications in various...more

Vidya TadapatriMSc (Biotechnology)

Vidya did her post-graduation in Biotechnology from Osmania University, Hyderabad. Her interest in scientific research and writing made her pursue a career in writing, in which she now has over five years of experience. She has done certified biotechnology-related training programs under renowned organizations such as Centre For Cellular & Molecular Biology and Department of Biotechnology. Vidya writes health-based articles...more