Erythema Infectiosum

Basics

Description

  • Characteristic viral exanthem also known as fifth disease:
    • Fifth most common childhood rash historically described
    • Measles (first), scarlet fever (second), rubella (third), Duke disease (fourth), roseola (sixth)
  • Common symptoms:
    • Viral prodrome
    • Followed by slapped-cheek rash
    • Then subsequent diffuse reticular rash +/− arthropathy
  • Most common in school-aged children <14 yr
  • Usually self-limited with lasting immunity
  • Rare complications and chronic cases in patients with congenital anemias or immunosuppression
  • Potential for severe complications to fetus if infection acquired during pregnancy
  • Possible link to encephalopathy, epilepsy, meningitis, myocarditis, dilated cardiomyopathy, autoimmune hepatitis, HSP, ITP

Etiology

  • Caused by human parvovirus B19, small SS-DNA virus:
    • Infects human erythroid progenitor cells, suppressing erythropoiesis
  • Most common in late winter and spring
  • Transmitted via respiratory droplets and blood products as well as vertical maternal–fetal transmission
  • Incubation period 4–21 d
  • Most contagious during the week PRIOR to rash onset
  • Majority of adults have serologic evidence of prior infection

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