Visual Diagnosis

Case:: A 5-year-old boy presents with red cheeks for the past 2 days and mild fever. He also has a faint lacy rash on his lower extremities.

Photo Credit: Ee Tay, MD and Sylvian Garcia, MD

Diagnosis:

This patient has parvovirus.

Parvovirus is also known as 5^th disease, slapped-cheeks disease, erythema infectiosum, or human parvovirus B19. Most people present with mild cold-like symptoms, while 25% to 50% of people who are infected are asymptomatic. Complications include rash, arthropathy, and transient aplastic anemia in immunocompromised patients. Vertical transmission to a fetus from maternal exposure during pregnancy may lead to a 2% to 10% chance of hydrops fetalis. Parvovirus infection is common during the summer season.

Clinical Practice Pearls:

• Parvovirus is usually self-limiting and requires no further treatment.

• Management should be targeted at reducing symptoms, such as using anti-inflammatory medications for arthropathy or performing transfusions for aplastic anemia. 

• Diagnosis is usually through clinical presentation, although IgM testing is recommended for immunocompromised patients. 

Additional Reading:

1. Servey JT, Reamy BV, Hodge J. Clinical presentations of parvovirus B19 infections. Am Fam Physician. 2007;75(3):373-376.
    
2. Broliden K, Tolfvenstam T, Norbeck O. Clinical aspects of parvovirus B19 infections. J Intern Med. 2006;260(4):285-304.