Roseola typically starts with what symptom?

Roseola, also known as sixth disease or exanthema subitum, is characterized by a sudden high fever as its initial symptom. This fever can reach up to 105°F and typically lasts for three to five days. Following the fever, a rash usually develops, which often appears as the fever subsides. This pattern of a high fever preceding the rash is hallmark to roseola's presentation, making it distinct from other viral infections that may have different initial symptoms.

The other symptoms listed, such as sore throat, itchy skin rash, or swollen lymph nodes, are not typically the first signs of roseola. In fact, sore throat can be associated with other viral infections like adenovirus or streptococcal pharyngitis, while itchy skin rashes generally occur after the fever subsides in roseola, rather than being an initial symptom. Swollen lymph nodes might be present, but they do not characterize the onset of the disease. Thus, the sudden high fever is the classic starting point for diagnosing roseola.