Erythema infectiosum

Background

• Caused by Parvovirus B19
• May precipitate aplastic crisis in patients with sickle cell disease
  • Disruption of hematopoiesis
• Infection in pregnancy
  • Hydrops fetalis and fetal loss

Clinical Features

• Initially mild URI-type symptoms
• "Slapped cheeks" rash
  • Abrupt appearance on day 3-4
    • Spares eyelids and chin
  • Lasts 4-5 days
• 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
• Associated symptoms include fever, HA, sore throat, cough, coryza, N/V

Complications

• Symmetric Polyarthropathy
• Myocarditis
• Pericarditis
• Glomerulonephritis
• Focal Glomerulosclerosis

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)

Management

• Symptomatic therapy

See Also

• Pediatric Rashes