Erythema infectiosum: Difference between revisions
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==Background== | ==Background== | ||
*Caused by Parvovirus B19 | *Also known as "Fifth disease" | ||
*May precipitate aplastic crisis in patients with sickle cell 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== | ==Clinical Features== | ||
*Initially mild URI-type symptoms | *Initially mild [[URI]]-type symptoms | ||
*"Slapped cheeks" rash | **Malaise, myalgias, and headache 7-10 days prior to rash <ref>Sara Bode; Contagious Exanthematous Diseases. ''Quick References 2022''; 10.1542/aap.ppcqr.396150</ref> | ||
*"Slapped cheeks" [[rash]] | |||
**Abrupt appearance on day 3-4 | **Abrupt appearance on day 3-4 | ||
***Spares eyelids and chin | ***Spares eyelids and chin | ||
**Lasts 4-5 days | **Lasts 4-5 days | ||
*Macular erythema develops on trunk/limbs 2 days after appearance of facial rash | *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 | **May last 1 week | ||
**Rash may recur within 3 week period | **Rash may recur within 3 week period | ||
*Associated symptoms include fever, | *Papulopurpuric glove-and-sock syndrome | ||
**[[Pruritus|Pruritic]] or painful [[petechiae]]/purpura limited to the hands and feet. <ref> 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 </ref> | |||
*Associated symptoms include [[fever]], [[headache]], [[sore throat]], [[cough]], coryza, [[nausea and vomiting]] | |||
[[File:Fifth disease.jpg|thumb|Fifths Disease]] | |||
==Differential Diagnosis== | |||
{{Peds Rash DDX}} | |||
==Evaluation== | |||
*Clinical diagnosis, based on history and physical exam | |||
==Management== | |||
*Symptomatic | |||
==Disposition== | |||
*Discharge most patients | |||
**Referral to maternal-fetal medicine specialist for infection in pregnancy | |||
*Admit if [[aplastic crisis]] | |||
==Complications== | ==Complications== | ||
| Line 24: | Line 42: | ||
*[[Glomerulonephritis]] | *[[Glomerulonephritis]] | ||
*Focal Glomerulosclerosis | *Focal Glomerulosclerosis | ||
==See Also== | ==See Also== | ||
*[[Pediatric Rashes]] | *[[Pediatric Rashes]] | ||
[[Category: | ==References== | ||
<References/> | |||
[[Category:Dermatology]] | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category: | [[Category:Pediatrics]] | ||
Latest revision as of 20:24, 2 November 2022
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
- Malaise, myalgias, and headache 7-10 days prior to rash [1]
- "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
Differential Diagnosis
Pediatric Rash
- Atopic dermatitis
- Bed bugs
- Contact dermatitis
- Drug rash
- Erythema infectiosum (Fifth disease)
- Hand-foot-and-mouth disease
- Henoch-schonlein purpura (HSP)
- Herpangina
- Herpes simplex virus (HSV)
- Infectious mononucleosis
- Meningitis
- Measles
- Molluscum contagiosum
- Roseola infantum
- Rubella (German measles)
- Scabies
- Scarlet fever
- Smallpox
- Varicella (Chickenpox)
Evaluation
- Clinical diagnosis, based on history and physical exam
Management
- Symptomatic
Disposition
- Discharge most patients
- Referral to maternal-fetal medicine specialist for infection in pregnancy
- Admit if aplastic crisis
Complications
- Symmetric Polyarthropathy
- Myocarditis
- Pericarditis
- Glomerulonephritis
- Focal Glomerulosclerosis
See Also
References
- ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
- ↑ 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