Lecture
Patient will present as → a 4-year-old who is brought to the office by his mother. The child has had a low-grade fever, headache, and sore throat for the past week. Four days ago, he suddenly developed a bright red rash on his cheeks, which during the past 2 days has spread to the trunk, arms, and legs. On physical examination, the child has erythema of the cheeks and a maculopapular rash with central clearing on the trunk spreading to the extremities. There are no other significant findings.
Erythema infectiosum is a common viral exanthem observed in pediatric patients caused by parvovirus B-19.
- Slapped cheek rash on the face with circumoral pallor 2-4 days of lacy reticular rash on extremities.
- Often preceded by no prodrome sequence, with low-grade fever at most.
- Sickle cell patients are at high-risk of developing aplastic crises with this disease.
Diagnosis is based primarily on clinical observations, history, and physical exam
- Serology: associated with enlarged nuclei with peripherally displaced chromatin
- PARVO B19-specific IgM antibodies and PCR
In the first stage, a bright red rash appears on the cheeks and forehead with circumoral pallor.
Observation alone
- Treatment is symptomatic
- The rash may last a few days to several weeks. It is frequently pruritic
- There is no specific antiviral used and no vaccine is available
 Osmosis |
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(Erythema infectiosum lecture begins at 1:15) |
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Erythema infectiosum or Fifth's Disease is a mild viral infection that is characterized by the slapped face appearance. It typically occurs in school-age children; however, adults can contract the disease. Pain and swelling in the joints (polyarthropathy syndrome) is a common finding in adult women with the disease. It is transmitted by respiratory secretions, blood, and blood products. The period of communicability is uncertain and the incubation period is 4 to 14 days and may be as long as 21 days. Isolation is not necessary.
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Question 1 |
Staphylococcus Hint: See B for explanation | |
Parvovirus-B19 | |
Herpes simplex virus Hint: See B for explanation | |
Cytomegalovirus Hint: See B for explanation |
Question 2 |
Sickle cell anemia Hint: See B for explanation | |
Megaloblastic anemia | |
Thalassemia Hint: See B for explanation | |
G6PD deficiency Hint: See B for explanation |
Question 3 |
Lyme disease ------------- Erythema marginatum Hint: Lyme disease ------------- Erythema migrans | |
Rheumatic fever ------------- Erythema nodosum Hint: Rheumatic fever ------------- Erythema marginatum | |
Parvovirus-B19 --------------- Erythema infectiosum | |
Infectious mononucleosis ------------ Erythema migrans Hint: Infectious mononucleosis ------------ Erythema nodosum |
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List |
