Doctor's Notes on Fifth Disease
Fifth disease (also called erythema infectiosum, or EI) is a mild viral illness that usually occurs during winter and spring, and most commonly in children aged 5 to 14 years.
Symptoms of fifth disease begin as mild vague illness. Early symptoms last several days and include low-grade fever, runny or stuffy nose, mild sore throat, fatigue, muscle aches, and a headache. About one week to 10 days later, the characteristic bright red facial rash (slapped cheeks appearance) suddenly develops and then fades within about four days. As the red facial rash fades, a light pink rash appears on the arms and may spread to the trunk, buttocks, and thighs. This light pink rash then gradually fades to a lacy pattern that lasts three to four days before going away.
Fifth Disease Symptoms
- Fifth disease usually starts as a mild vague illness and nonspecific symptoms. Low-grade fever occurs 15%-30% of the time, along with nasal congestion and drainage, mild sore throat, fatigue, muscle aches, and a headache. This lasts for several days.
- Then, seven to 10 days later, the characteristic facial rash (slapped cheeks appearance) develops abruptly. Typically, the facial rash is bright red. The child looks as if a hand has been slapped across his or her face. This rash fades within approximately four days.
- As the slapped cheek skin changes fade, a light pink rash begins on the arms and then may spread to the trunk, buttocks, and thighs. This gradually fades to a lacy pattern lasting three to four days and then clears.
Fifth Disease Causes
Infection with human parvovirus B19 was identified as the cause of fifth disease in 1975, although Robert Willan first reported the rash in 1799 as "rubeola, sine catarrho" (rubeola, measles without cough).
Finding a bump, rash, red mark, or welt on a child's body is more common than not finding one. Most of these are not worrisome; however, some may be more concerning than others. We will present some information about common skin findings in this slide presentation to help patient's better identify them. As always, if there is any concern, always consult the child's doctor to be sure.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.