Illustrative CasesThe Not-So-Soft Spot Pathophysiology of the Bulging Fontanelle in Association With RoseolaCristoforo, Thomas DO∗,†; Le, Nicole K. BS‡; Rye-Buckingham, Summer MD∗,†; Hudson, William B. MS‡; Carroll, Leslie F. MD†Author Information From the ∗Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa †Johns Hopkins All Children's Hospital, St Petersburg ‡Morsani College of Medicine, University of South Florida, Tampa, FL. Disclosure: The authors declare no conflict of interest. Reprints: Thomas A. Cristoforo, DO, Department of Pediatrics, Morsani College of Medicine of the University of South Florida, 17 Davis Blvd, Tampa, FL 33616 (e-mail: [email protected]). Pediatric Emergency Care: October 2020 - Volume 36 - Issue 10 - p e576-e578 doi: 10.1097/PEC.0000000000001447 Buy Metrics Abstract Roseola infantum is a clinical syndrome characterized by high fever followed by the emergence of a rash. Case reports have documented an association between bulging fontanelles and roseola. We propose a novel mechanism for the development of intracranial hypertension caused by human herpesvirus 6–induced cytokine elevation leading to increased cerebrospinal fluid production. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.