Which statement about rubella and roseola is true regarding posterior auricular lymphadenopathy?

• A. It is seen only in rubella.
• B. It can be seen in both rubella and roseola.
• C. It is seen only in roseola.
• D. It is never seen in either.

Answer: (B)

Posterior auricular lymphadenopathy is most classically associated with rubella, reflecting the facial/occipital drainage pattern involved in this infection. But this regional lymph node finding is not exclusive to rubella. In viral illnesses, including roseola, some children can develop cervical or posterior head-and-neck lymphadenopathy as part of the generalized immune response. Since rubella reliably causes posterior auricular nodes and roseola can sometimes show similar lymphadenopathy despite its hallmark fever followed by a rose-pink rash, this finding can be seen in both.