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Erythema Infectiosum, Emergency Medicine

Benjamin S. Heavrin Reviewed 06/2017
 


Basics

Description

  • Characteristic viral exanthem also known as 5th disease:

    • 5th most common childhood rash historically described

    • Measles (1st), scarlet fever (2nd), rubella (3rd), Duke disease (4th), ro...

Diagnosis

Signs and Symptoms

  • “Slapped-cheek” appearance most common in young children

  • Fever

  • Malaise

  • Delayed symptoms 4–14 days later:

    • Diffuse, pruritic, lacy rash (absent in most adults), most pronounced i...

Treatment

Erythema infectiosum is usually self-limited and does not require treatment 

Pre-Hospital

ABCs for severe cases and septic patients 

Initial Stabilization/Therapy

  • ABCs, supplemental oxygen if in...

Follow-Up

Disposition

Admission Criteria

  • Aplastic crisis or severe anemia

  • Severely immunocompromised

  • Hydrops fetalis

  • Toxic appearance

  • Severe arthritis

Discharge Criteria

  • Nearly all patients

  • Normal CBC, O2 sat,...

Pearls and Pitfalls

  • Parvovirus B19 is usually a self-limited, mild illness.

  • Common symptoms include “slapped-cheeks” rash with subsequent diffuse lacy rash and arthropathy

  • Patients are no longer contagi...

Additional Reading

  • Servey  JT, Reamy  BV, Hodge  J. Clinical presentations of parvovirus B19 infection. Am Fam Physician.  2007;75:373–376.

  • Vafaie  J, Schwartz  RA. Erythema infectiosum. J Cutan M...

Codes

ICD9

057.0 Erythema infectiosum (fifth disease) 

ICD10

B08.3 Erythema infectiosum [fifth disease] 

SNOMED

  • 34730008 erythema infectiosum (disorder)

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