Pediatric Erythema infectiosum / 5th disease / Slapped cheek disease (Pediatrics - PEDS)

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Megaloerythema is a typical childhood skin disease of viral origin. It usually has a good prognosis.

It is caused by a virus called parvovirus B19. The virus is spread by contact with secretions (saliva, mucus). It has an incubation period of 1-2 weeks before symptoms appear.

The most common symptoms are: redness of both cheeks, redness/eruption of the skin on the trunk and extremities (in the form of "lace"), rash on hands and feet in the form of "gloves and socks", fever, headache and mucus. In rare cases it causes anemia, bleeding and a decrease in white blood cells.

Diagnosis is usually clinical, by interview and physical examination.

Symptoms should be treated with analgesics and/or antipyretics. Prognosis is usually good with no lasting effects. Parvovirus B19 infection is more dangerous for the developing fetus, so contact between infected patients and pregnant women should be avoided.

Bibliographic references
  1. Young NS, Brown KE. Parvovirus B19. N Engl J Med 2004; 350:586.
  2. Fretzayas A, Douros K, Moustaki M, Nicolaidou P. Papular-purpuric gloves and socks syndrome in children and adolescent. Pediatr Infect Dis J. 2009 Mar;28(3):250-2.
  3. Torok TJ. Unusual clinical manifestations reported in patients with parvovirus B19 infection. In: Monographs in Virology: Human Parvovirus B19, Anderson LJ, Young NS (Eds), Karger, New York 1997. p.61.
  4. Francesco Drago, Giulia Ciccarese, Francesco Broccolo, Sanja javor, Aurora Parodi. Atypical exanthems associated with Parvovirus B19 (B19V) infection in children and adults. J Med Virol. 2015 Nov;87(11):1981-4.
  5. Pedranti MS, Barbero P, Wolff C, Ghietto LM, Zapata M, Adamo MP. Infection and immunity for human parvovirus B19 in patients with febrile exanthema. Epidemiol Infect. 2012 Mar;140(3):454-61.
Author
Dr. Maria Trabazo
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© TeckelMedical 2026

Symptoms

    Red cheeks


    "Lace-like" skin reddening or rash


    Itch and reddening in glove / sock shape


    Skin alteration


    Fever / Feel very hot

Symptoms to watch out for

History of anemia
Pregnancy
Fever not relieved by antipyretics (paracetamol, ibuprofen)
History of immunodeficiency (HIV, Diabetes Mellitus, oncological disorders, long-term corticosteroid consumption).

Self-care

Use over-the-counter analgesics and antipyretics for muscle pain or fever (temperature > 100.4 F).
Maintain a fluid intake of 6 - 8 cups per day.
Avoid contact with pregnant women.