A viral illness caused by infection with parvovirus B19.
The classic childhood presentation is a "slapped cheek" appearance followed by a reticular, erythematous eruption that is predominantly found on the extremities and may be preceded by mild systemic symptoms. Adults, more than children, may report arthritis and arthralgias.
Most cases do not require specific treatment beyond symptomatic therapy and reassurance.
Infection in pregnant women may result in fetal anemia, hydrops fetalis, or intrauterine death.
Persistent infection, lasting longer than approximately 3 weeks and accompanied by chronic anemia, may occur in people who are immunosuppressed (e.g., patients with HIV, people receiving chemotherapy or immunosuppression following transplant, or patients with congenital immunodeficiencies).
People with a high RBC turnover/destruction (e.g., those with hereditary spherocytosis, sickle cell disease, thalassemia, iron deficiency anemia) may develop transient aplastic crisis.
Typical erythematous "slapped cheeks" of erythema infectiosum
From the collection of Gary A. Dyer, MD
- close contact with other infected individuals
- bright red macular erythema of the bilateral cheeks with sparing of the nasal ridge and perioral areas
- erythematous macules and papules evolving into lacy reticular erythema, most notable on the extremities
- symptoms of anemia
- prodrome (fever, headache, pharyngitis, coryza, abdominal pain)
1st Tests To Order
- clinical diagnosis
Other Tests to Consider
- reticulocyte count
- DNA assays
- acetaminophen plus supportive therapy
- nonsteroidal anti-inflammatory drugs (NSAIDs)
persistent (>3 weeks) parvovirus B19 infection
- removal or reduction of underlying immunosuppression plus treatment with intravenous immunoglobulin (IVIG)
- RBC transfusion