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Erythema infectiosum

Last reviewed: 3 May 2025
Last updated: 15 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • 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
  • immunodeficiency
Full details

Other diagnostic factors

  • arthralgia/arthritis
  • prodrome (fever, headache, pharyngitis, coryza, abdominal pain)
  • symptoms of anemia
Full details

Risk factors

  • close contact with other infected individuals
  • immunodeficiency
  • age 6 to 10 years
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

  • CBC
  • reticulocyte count
  • serology
  • DNA assays
Full details

Treatment algorithm

ACUTE

fever

secondary arthritis

ONGOING

persistent (>3 weeks) parvovirus B19 infection

Contributors

Authors

Joseph M. Lam, MD

Clinical Associate Professor, Department of Pediatrics

Associate Member, Department of Dermatology and Skin Sciences

University of British Columbia, BC Children’s Hospital

Vancouver

BC

Canada

Disclosures

JML declares that he has no relevant competing interests.

Alexander K. C. Leung, MD

Department of Pediatrics

The University of Calgary, Alberta Children's Hospital

Calgary

Alberta

Canada

Disclosures

AKCL declares that he has no relevant competing interests.

Acknowledgements

Dr Joseph M. Lam and Dr Alexander Leung would like to gratefully acknowledge Dr Kari L. Martin, Dr Christine T. Lauren, Dr Jon Dyer, and Dr Jennifer Holman, the previous contributors to this topic. KLM has served as a board member for Women's Dermatologic Society and American Contact Dermatitis Society. CTL, JD, and JH declare that they have no competing interests.

Peer reviewers

Nevio Cimolai, MD

Professor

Department of Pathology and Laboratory Medicine

Children's and Women's Health Centre of British Columbia

Vancouver

Canada

Disclosures

NC declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Young NS, Brown KE. Parvovirus B19. N Engl J Med. 2004;350:586-597. Abstract

UK Health Security Agency. Parvovirus B19: guidance, data and analysis. Aug 2024 [internet publication].Full text

Cherry JD. Parvovirus infections in children and adults. Adv Pediatr. 1999;46:245-69. Abstract

Kimberlin DW, Banerjee R, Barnett ED, et al. Red book: 2024-2027 report of the Committee on Infectious Diseases. 33rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2024.

Centers for Disease Control and prevention. Parvovirus B19 and fifth disease. Nov 2019 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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