Erythema infectiosum
Background
- Also known as "Fifth disease"
- Caused by Parvovirus B19
- Infection in pregnancy can → Hydrops fetalis, fetal anemia, and fetal loss
- May precipitate aplastic crisis in patients with sickle cell disease
Clinical Features
- Initially mild URI-type symptoms
- "Slapped cheeks" rash
- Abrupt appearance on day 3-4
- Spares eyelids and chin
- Lasts 4-5 days
- Abrupt appearance on day 3-4
- Macular erythema develops on trunk/limbs 2 days after appearance of facial rash
- Distinctive aspect of rash: faces with central clearing, giving a reticulated or lacy appearance
- May last 1 week
- Rash may recur within 3 week period
- Papulopurpuric glove-and-sock syndrome
- Associated symptoms include fever, headache, sore throat, cough, coryza, nausea and vomiting
Fifths Disease
Differential Diagnosis
Evaluation
- Clinical diagnosis, based on history and physical exam
Management
- Symptomatic
Disposition
- Discharge
- Admit if aplastic crisis
- Referral to maternal-fetal medicine specialist for infection in pregnancy
Complications
- Symmetric Polyarthropathy
- Myocarditis
- Pericarditis
- Glomerulonephritis
- Focal Glomerulosclerosis
See Also
- Pediatric Rashes
References
- Shirk A, Sorrentino A. Viral Exanthems. In: Schafermeyer R, Tenenbein M, Macias CG, Sharieff GQ, Yamamoto LG. eds. Strange and Schafermeyer's Pediatric Emergency Medicine, 4e. New York, NY: McGraw-Hill; 2015
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