Erythema infectiosum

• Erythema infectiosum:

  • Caused by parvovirus B19
  • Also called slapped cheek syndrome or fifth disease
• Clinical features:

  • Starts with mild fever, coryza and non-specific viral symptoms
  • After 2-5 days a rash appears rapidly - diffuse bright red rash on both cheeks
  • A few days later a reticular (lace like) mildly erythematous rash affecting the trunk and limbs appear
  • Rash can be raised and itchy
• Prognosis:

  • Illness is self limiting and rash/symptoms usually fade over 1-2 weeks
  • Healthy adults and children have a low risk of any complications and are managed supportively
  • No longer infectious once the rash has formed so do not need to stay off school
• Patients at risk of complications:

  • Immunocompromised patients, pregnant women and patients with haematological conditions e.g. sickle cell anaemia
  • These patients require serology testing to confirm parvovirus infection
  • Check FBC and reticulocyte count of aplastic anaemia
  • People that would be at risk of complications that have come into contact with an infected person prior to the rash forming, should be informed and may need investigations
• Complications:

  • Aplastic anaemia
  • Encephalitis or meningitis
  • Pregnancy complications including fetal death
  • Rarely hepatitis, myocarditis or nephritis