Erythema infectiosum: Difference between revisions

(Text replacement - "HA" to "headache")
 
(2 intermediate revisions by 2 users not shown)
Line 3: Line 3:
*Caused by [[Parvovirus B19]]
*Caused by [[Parvovirus B19]]
**Infection in pregnancy can → [[Hydrops fetalis]], fetal anemia, and fetal loss
**Infection in pregnancy can → [[Hydrops fetalis]], fetal anemia, and fetal loss
**May precipitate aplastic crisis in patients with sickle cell disease
**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
**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
*Papulopurpuric glove-and-sock syndrome
*Papulopurpuric glove-and-sock syndrome
**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>
**[[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
*Associated symptoms include [[fever]], [[headache]], [[sore throat]], [[cough]], coryza, [[nausea and vomiting]]


[[File:Fifth disease.jpg|thumb|Fifths Disease]]
[[File:Fifth disease.jpg|thumb|Fifths Disease]]
Line 31: Line 32:


==Disposition==
==Disposition==
*Discharge
*Discharge most patients
*(Admit if aplastic crisis)
**Referral to maternal-fetal medicine specialist for infection in pregnancy
*Referral to maternal-fetal medicine specialist for infection in pregnancy
*Admit if [[aplastic crisis]]


==Complications==
==Complications==

Latest revision as of 20:24, 2 November 2022

Background

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
  • 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

Pediatric Rash

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

See Also

References

  1. Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
  2. 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