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Registered Nurse (RN)
Pediatric Nursing
Childhood Viral Exanthems
Erythema Infectiosum (Fifths Disease)

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Erythema Infectiosum (Fifths Disease)

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Erythema Infectiosum (Fifths Disease)

Earth-red (5)
Erythema infectiosum or Fifth’s Disease is mild viral infection that is characterized by the “slapped face” appearance. It typically occurs in school-age children; however, adults can contract the disease. Pain and swelling in the joints (polyarthropathy syndrome) is a common finding in adult women with the disease. It is transmitted by respiratory secretions, blood, and blood products. The period of communicability is uncertain and the incubation period is 4 to 14 days and may be as long as 21 days. Isolation is not necessary.
Human Parvovirus B19
Human with Par-4-virus having Brunch at the 19th hole

Parvovirus B19 is a viral infection that is benign. It is transmitted by respiratory secretions, blood and blood products.

Cold-like Symptoms
Cold with Thermometer and Ice-bag

Prodromal symptoms like fever, runny nose and a headache usually occur within 1 week of exposure to the virus.

Three Stage Rash
(3) Tree Rash

This viral infection occurs classically in three stages. It includes a face rash, followed by a truncal rash, which is then followed by a phase of reappearances of the truncal rash.

Slapped Face
Slapped Face

This is the most classically known symptom of erythema on the cheeks that makes the child look as if they have just been “slapped.”

Maculopapular Red Spots on Trunk
Red Mac-glow-papule-people on Trunk

24 hours following face rash, a maculopapular rash on the trunk appears symmetrically on upper and lower extremities. This lasts about 1 week.

Rash Reappears
Reappearing Rash

The third phase of this disease is a clearing and recurrence of the rash. This occurs usually if the skin is irritated or traumatized by sunlight, heat, cold, or friction.

Aplastic Crisis
A-plastic-bottle Crying

Reticulocytopenia or aplastic crisis occurs in children with weakened immune systems – leukemia, HIV+, and other hemolytic diseases. These patients have decreased numbers of white blood cells.

Joint Pain and Swelling
Swollen Joint with Pain-bolts

This is a self-limiting complication usually occurring in adult women.


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