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Image Number 740 (Erythema infectiosum)


Diagnosis: Erythema infectiosum

Site: Cheek

Sex: M

Age: 6

Type: Clinical

Description: Symmetrical bright red cheeks, the rash does not extend over the bridge of the nose or around the mouth.

Submitted by: Mehravaran Mehrdad

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Differential Diagnosis


Parvovirus B19 was discovered, by chance in 1975 by the Australian virologist Yvonne Cossart.1 Parvovirus B19 is best known for causing a childhood exanthem called fifth disease or erythema infectiosum. The B19 virus belongs to the Parvoviridae family of small DNA viruses. Erythema Infectiosum rash appearing as  bright red cheeks is a defining symptom of the infection in children (hence the name "slapped cheek disease"), but the rash does not extend over the bridge of the nose or around the mouth. In addition to the 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. Patients are usually no longer infectious once the characteristic rash of this disease has appeared. Any age may be affected although it is most common in children aged six to ten years (school age). Outbreaks can arise especially in nurseries and schools. The disease is usually mild, but it does have the ability to cause some serious problems: it is associated with spontaneous abortion in pregnant women, and with transient aplastic crisis in persons with chronic hemolytic anemia. Primary infection in the first trimester has been linked to hydrops fetalis. The rash can last a couple of weeks and may itch.

A 6-year-old afebrile boy with chief complaint of symmetrical bright red cheeks which appeared after a high fever. Parents were reassured, lesions settled fully after 7 days, only emolliant was applied. References: 1. Cossart YE, Field AM, Cant B, Widdows D. "Parvovirus-like particles in human sera". Lancet 1 (7898): 72-3, 1975.

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