Clinical: Erythema Infectosum

Often called "fifth disease" (referring to a naming system that formerly identified pediatric exanthemas by number), erythema infectosum is caused by parvovirus B19. It can affect any human, but most often affects children between the ages of 5 and 15.[1]

Although innocuous in most children, erythemia infectosum can cause aplastic crisis in patients with hemoglobinopathies, hemolytic anemia, or immunodeficiency. It can also cause fetal hydrops in pregnant women.


A mild prodromal phase consists of low-grade fever, headache, and malaise, and sometimes arthralgia, arthritis, conjunctivitis, cough, and diarrhea. This is followed by brilliant red patches on the cheeks (the "slapped cheek" sign) which normally fades within hours to a few days, followed by a generalized rash on the neck, body, and extremities. The rash is diagnostic. Once it appears, the patient is no longer contagious.


There is no specific antiviral therapy for erythema infectiosum. The symptoms of the prodrome are usually treated with acetaminophen or ibuprofen to relieve fever and discomfort.


  1. Gibson WA. Rashes and fevers in children: Sorting out the potentially dangerous - Part 3. Consultant for Pediatricians 8:8 (2009)
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