Fifth disease (erythema infectiosum)

Skin | Dermatology | Fifth disease (erythema infectiosum) (Disease)


Fifth disease is a viral illness that leads to a rash on the cheeks, arms, and legs. The disorder is also called erythema infectiosum and produces a characteristic slapped cheek rash. It is most often seen in children 5-14 years of age and is spread by sneezing and coughing of the virus through the air. The name of the virus that causes the disease is human parvovirus B19.

Bright red cheeks are a defining symptom of the infection in children (hence the name slapped cheek disease). Occasionally the rash will extend over the bridge of the nose or around the mouth. In addition to red cheeks, children often develop a red, lacy rash on the rest of the body, with the upper arms and legs being the most common locations. The rash typically lasts a couple of days and may itch; some cases have been known to last for several weeks. Patients are usually no longer infectious once the rash has appeared.

Causes and Risk factors

A child with erythema infectiosum has a red rash caused by a virus. The rash usually starts on the cheeks before spreading to the rest of the body. The rash usually resolves within 2 weeks. About 70 percent of erythema infectiosum occur in children between 5 and 15 years old. About 60 percent of adults have been infected with the virus during childhood.

Teenagers and adults may present with a self-limited arthritis. It manifests in painful swelling of the joints that feels similar to arthritis. Older children and adults with fifth disease may have difficulty in walking and in bending joints such as wrists, knees, ankles, fingers, and shoulders.

Diagnosis and Treatment

No specific treatment is usually required. Patients are encouraged to drink plenty of fluids. Acetaminophen (Tylenol) is given to help relieve the fever and joint pain. ...

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