Infectious erythema in children and adults - symptoms and treatment. Fifth disease - erythema infectiosum Viral erythema treatment

Redness on the skin of the baby is caused by various reasons - allergies, exposure to the external environment, and maybe a manifestation of an infectious disease called erythema. Its symptoms are similar to SARS. If such signs are found in the baby, it must be shown to the doctor. Self-treatment is unlikely to be effective.

What is erythema infectiosum?

It can be both an independent disease and a symptom of other ailments. In general, the term combines several diseases with characteristic signs. All of them are distinguished by a strong reddening of certain areas of the skin.

Often, erythema affects children, including newborns, who still do not have enough defenses to fight pathogens. The most common infectious forms caused by various viruses and bacteria. These include:

• Chamer's erythema - provoked by the human paravirus B19;
• erythema annulare Leiner - caused by streptococcus;
• multiform exudative form - it is caused by pathogens of infectious diseases (tonsillitis, sinusitis, diphtheria, whooping cough, pulpitis, tonsillitis, etc.);
• erythema nodosum - appears with rheumatism, tuberculosis, rheumatism and looks like seals on the limbs with pain;
• sudden erythema (exanthema) - caused by the herpes virus;
• undifferentiated infectious form;
• pink lichen Zhibera (we recommend reading:);
• erythema Rosenberg;
• streptoderma (“fly”) with annular erythema (we recommend reading:);
• toxic form and others.

There are many types of this disease, all of them are caused by different causes and pathogens. There is also physiological erythema, which is not a pathology and is caused by external factors. It manifests itself in the first three days of a newborn baby's life and passes without a trace on its own.

Causes of the disease

In newborns, the main cause of the disease is the immaturity of the immune system. It happens that infection occurs even in utero or during childbirth.

In older children, erythema occurs due to:

• bacterial, viral infection;
• toxic effects;
• allergic reactions;
• other unknown factors.

Symptoms of different types of infectious erythema

Due to the fact that the disease is caused by different causes, its manifestations and the duration of the course also differ and cause concomitant symptoms.

On the fifth day of the disease, the baby has red spots on the face, then all over the body. The spots are very itchy and disappear after a few days. Their characteristic manifestation can be seen in the photo.

The infectious form of the disease is transmitted by airborne droplets. After the disease, a strong immunity is formed, the baby will not be able to get sick with it anymore.

Diagnosis of pathology

A dermatologist deals with such diseases - it is to him that a child should be taken if an infectious erythema is suspected. Each type of disease has its own characteristic signs, therefore, during a visual examination, the specialist will determine what exactly struck the baby's skin.

Additionally, a general blood test is prescribed, since this ailment often gives accompanying symptoms. Another necessary study for infectious erythema is a blood test for ELISA, the presence of antibodies in the blood, and the detection of virus DNA. If necessary, the baby will be referred to an infectious disease specialist.

Methods of treatment

Treatment of infectious erythema is prescribed depending on the type of disease and the cause that caused it. The doctor will pay attention to clinical symptoms (skin and the degree of its damage) and test results.

As a rule, uncomplicated cases are treated at home with mandatory bed rest. If the child has a seriously weakened immune system or has a blood disease, the specialist will offer to undergo therapy in a hospital.

When treating a disease, it is important not to limit the child to liquids, but on the contrary, to offer to drink pure non-carbonated water as often as possible.

• give the baby enough liquid to remove toxins from the body;
• exclude taking a bath, hygiene procedures should be carried out only in the shower;
• you can not expose the skin to negative influences (cold, heat, sun) - they greatly delay recovery;
• clothes should be washed at temperatures above 60 degrees;
• underwear (shirts, shorts) to change every day.

Medical method

Drugs acceptable for pediatric therapy:

1. Antiseptic local remedies (Dimexide). Helps relieve itching and heal damaged skin faster.
2. Antipyretics (Paracetamol for children, Nurofen). They are used at temperatures above 38.5 ° C to alleviate the condition of a sick baby, they have an analgesic effect.
3. Immunostimulants (Viferon). Support immunity in the fight against the virus.
4. Antihistamines (Fenistil). Reduce allergic manifestations.
5. Antibiotics (Flemoxin Solutab) (we recommend reading:). They are prescribed to cure the main or secondary disease (pneumonia, tonsillitis, otitis media). Erythema annulare in children also requires topical antimicrobial therapy (Erythromycin).

Physiotherapy

Physiotherapy procedures are used for erythema nodosum. As a rule, this is electrophoresis on the affected areas of the skin with solutions of potassium or sodium iodide. Sometimes it is recommended to carry out phonophoresis, laser therapy, ultraviolet radiation, magnetotherapy. Such treatment is prescribed by a dermatologist, because in some forms of erythema, physiotherapy will only hurt.

Power adjustment

The patient's diet is adjusted by analogy with other viral diseases. Fatty, fried, smoked foods are excluded. Excess salt should be avoided. The ban also applies to chocolate, canned food, fast food and citrus fruits. Allergenic foods will aggravate the condition of the baby and reduce the already weak immunity.

ethnoscience

Before using any folk remedy, you should consult with your doctor. Such methods should be used only in combination with traditional treatment.

Traditional medicine recipes suitable for the treatment of erythema in a child:

• decoctions of immortelle, mint, lemon balm, chamomile;
• berry decoctions;
• infusion of wild rose, red mountain ash, hawthorn, elderberry;
• lotions from oak bark, chamomile;
• arnica ointment.

Recovery prognosis

Infectious erythema, as a rule, disappears in 2-3 weeks. With proper treatment, the prognosis is favorable. There are no serious complications, scarring after the rash does not remain.

A common form of the disease - sudden exanthema - affects 30% of all children and is accompanied by severe symptoms, but does not pose a health hazard with adequate therapy (see also:). It passes within a week without complications. After recovery, lifelong immunity to sudden exanthema is formed.

Adverse consequences for children can occur with blood disorders, anemia - an infectious disease will aggravate the state of health. It will also negatively affect the baby with immunodeficiency. There is a high risk that erythema will go into a chronic stage.

Erythema multiforme exudative is also dangerous. It is caused by serious diseases and in itself is fraught with serious consequences. In especially neglected, complex cases, erythema multiforme exudative even leads to death.

Prevention measures

There is no specific prophylaxis against infection with the infectious form of the disease, because it is often asymptomatic and it is impossible to recognize the carrier of the infection.

It is easy to get infected with it in a clinic, transport, kindergarten or school. That is why the recommendations will be general for maintaining immunity:

• avoid large crowds of people;
• do not contact with patients with ARVI;
• wash hands after the street, rinse the nasal passages with saline during epidemics;
• eat fully and properly, take vitamin complexes (VitaMishki, Alphabet, Pikovit);
• do sport;
• sleep at least 8 hours a day;
• walk more outdoors.

If the baby has already been ill with infectious erythema, it is important to protect him from the recurrence of the disease. For this you need:

• avoid hypothermia and extreme heat;
• do not go out under the open scorching sun;
• protect the baby from stress, mental stress;
• take all measures to strengthen immunity.

Erythema infectiosum (fifth disease) is a group of viral diseases caused by type B19. The etiology of the disease is not fully known. The symptoms of erythema are similar to those of any other infection, making diagnosis difficult. Treatment is prescribed depending on the form of the disease. We will analyze the details in the article.

What is erythema infectiosum?

Causes of infection

There are different opinions about the ethology of the virus. There are suggestions that the "fifth disease" occurs against the background of the development of rheumatism, tuberculosis, tularemia, as a response of the body. Animals can be carriers of the B19 virus. Cases of infection with infectious erythema through scratches of a cat are known. B19 is a complex DNA virus with incredible resistance to physiological factors. At a temperature of 56 degrees, it is able to exist for about an hour.

The location of the virus is the cells of the bone marrow. The infection is transmitted through the air and in the process of blood transfusion from an infected person, as well as from mother to fetus through the umbilical cord.

Thus, the main causes of infectious erythema are:

• contact with a carrier of the virus;
• complications from past infectious diseases;
• side effect of taking sulfa drugs.

Clinical forms and symptoms

• sudden erythema. It is characterized by a sharp increase in body temperature - up to 38-39 degrees. At the same time, intoxication of the body proceeds in a moderate form. After 3-4 days, signs of fever are observed with a simultaneous rash of large spots in certain parts of the body. The rash disappears as abruptly as it appears after 3 days.
• Erythema Chamera. In this case, the rash appears immediately. In this case, the body temperature is not more than 37 degrees. Intoxication does not manifest itself in any way. Spots of red color are concentrated on the face in the form of a "butterfly". If the virus develops against the background of respiratory diseases, the rash may appear several times. In adults with this form of the disease, mild arthropathy is observed - vascular damage. Children easily cope with the disease.
• Erythema Rosenberg. This is a more severe case. From the first day, fever appears against the background of acute intoxication of the body. On the 4-5th day, red spots appear, merging together in the places of extension of the joints and buttocks. There is no rash on the face. After the temperature normalizes for 4-5 days, the spots disappear.
• . The virus develops against the background of infectious diseases. Fever with a high degree of intoxication is present from the first day. The lower limbs and forearms are covered in symmetry with painful red spots with seals inside in the form of knots. As it heals, the redness changes to a yellowish tint. Rashes persist up to 21 days.

• . This is a complicated form of Rosenberg. Against the background of the same symptoms, bubbles appear with a clear liquid inside. A complication of this form of erythema is Steven-Johnson Syndrome. Vesicles form on mucous membranes. Ulcers affect the mouth, throat, genitals, eyes, anus. After recovery, roughness and sores from vesicles remain on the skin for some time.

• The mildest degree of the disease. There is a slight fever. The rash appears in separate areas and quickly disappears.

• an increase in body temperature from 37 to 39 degrees;
• characteristic redness on certain parts of the body;
• loss of appetite;
• general malaise.

An increase in temperature is a determining factor in the development of any virus. It is necessary to seek help in a timely manner.

Diagnostics

Erythema infectiosum virus is not always recognized immediately. The disease is quite rare. Symptoms are comparable to diseases such as -, measles, erysipelas, scarlet fever, cutaneous leishmaniasis, leptospirosis, typhoid, lupus erythematosus and others. The symptoms of these diseases are almost identical.

Diagnosis of the "fifth disease" is made by the nature of redness. The rash has a rich red color and a large shape. Spots can “spill” over the face, which is why the disease is sometimes called “slapped cheek disease”. On the arms and legs, the rash looks like lace, rings, half rings, solid circles.

If erythema multiforme is detected, in particular, Steven-Johnson Syndrome, a consultation with a dermatologist is prescribed.

Treatment and prognosis

Pregnant women infected with the "fifth disease" are placed in a hospital for preservation. The treatment is carried out under the supervision of doctors and ultrasound control of the fetus.

Pregnant women who do not seek treatment in time are at risk of fetal loss.

• antihistamines;
• antipyretics;
• antibiotics (in the presence of microbes);
• antispasmodics.

The prognosis for identifying infectious erythema is positive. Until the first rash appears, the patient is isolated from contact with healthy people. As soon as spots appear, the virus becomes not dangerous. With the right approach, the "fifth disease" is easily treated.

Possible Complications

The presence of the B19 virus in the body gives a complication to the kidneys and liver. During the diagnosis, an increase in their size is observed. If there are health problems in this area, they can get worse.

The most difficult cases were noted in children suffering from

Description:

Erythema infectiosum is a common childhood disease. Adults can get sick too. Erythema infectiosum is also called the fifth disease because sometimes a rash appears on the face. The disease is spread by sneezing and coughing.

Typically, people spread erythema infectiosus when they have symptoms resembling that and before the rash appears. People who suffer from erythema infectiosum and certain blood problems or weak immune systems may spread the disease longer.

Causes of erythema infectiosum (fifth disease):

The development of the fifth disease is caused by the human parvovirus B19 virus.

Symptoms of erythema infectiosum (fifth disease):

The early symptoms of erythema infectiosum are flu-like. After a few days, a rash will appear, and some will experience joint pain. The development of erythema infectiosum can be confused with other diseases in which similar symptoms appear.

Flu-like symptoms.
Symptoms of erythema infectiosum develop 2 to 3 weeks after exposure to the virus. Usually, the initial symptoms resemble the development of the flu and may be so mild that no one notices them. Some people with erythema infectiosum have no symptoms at all. Initially, the following symptoms may appear:
Runny nose and sore throat.
Headaches and abdominal pain.
In rare cases, a slight fever may appear.
Weakness in the body and pain in the joints.

Rash.
A rash may appear about 7 days after the onset of flu-like symptoms, although rashes are not as common in adults as in children. Some people don't get a rash at all.

If a rash appears, it usually develops according to a predictable plan, going through two or three stages of development:
A bright red rash appears on the cheeks (often the cheeks look like they have been beaten), and sometimes the rash appears on the forehead and chin. This rash usually disappears in 2 to 5 days.
The rash may appear on the neck, trunk, forearm, upper knee, and buttocks. The rash starts as round red spots and then grows into a lace-like rash. The rash may itch, especially in older children. The second stage lasts a week or less.
After the rash on the body disappears, it can reappear from exposure to sunlight, high temperatures, or from stressful situations. This rash usually stays for 1 to 3 weeks. Even if the rash reappears, it does not mean that your condition is getting worse.

Joint pain.
Joint pain in the hands, wrists, ankles, and legs is common in adults, especially women. Pain usually lasts from 1 to 3 weeks, although in rare cases the pain may last longer. Usually, erythema infectiosum does not cause permanent joint damage.

Complications:

In the fifth disease, the body stops producing red blood cells for a short period. Usually in a healthy child or adult, this does not cause significant problems. However, this disease can pose a significant risk to people suffering from blood disorders such as sickle cell disease or thalassemia. Such people may develop a temporary aplastic crisis, which consists in the deterioration of the existing one and can last from 7 to 10 days. In people suffering from temporary aplastic anemia, the state of health can deteriorate very much; symptoms such as fever, apathy, increased heart rate, and rapid breathing may appear.

People with weak immune systems who get fifth disease can develop chronic parvovirus B19, which can lead to more severe anemia.

Treatment of erythema infectiosum (fifth disease):

For treatment appoint:

For normal healthy people with erythema infectiosum, normal home treatment (including rest, fluids, and pain medication) is sufficient. The reappearance of the rash does not mean that the disease is progressing or that the condition has worsened. Often the rash can reappear from exposure to sunlight, high temperatures, or from stressful situations.

Antibiotics are not used to treat erythema infectiosum because the disease is caused by a virus, not a bacterium.

Treatment for people at high risk.
However, pregnant women and people with weakened immune systems or blood problems, such as sickle cell disease or sickle cell disease, are at an increased risk of developing complications from fifth disease. Such people need to be under the supervision of specialists, and in case of contact with a sick person, they should see a doctor. Sometimes, hospitalization may be necessary to eliminate complications.

If you are pregnant and have been exposed to the fifth disease virus, your doctor may recommend a blood test to see if you have become infected or have developed immunity. If you have been infected, your doctor may recommend frequent fetal ultrasounds throughout your pregnancy.

Prevention of the spread of infectious erythema.
By the time the rash appears, you will no longer be a carrier of the disease. As soon as the child develops a rash, he can return to school or kindergarten.

People who become ill with erythema infectiosum, including those who develop complications, should take precautions to stop the spread of the virus. You must wash your hands frequently. If people with erythema infectiosum are hospitalized, they may be isolated from other patients.

A parvovirus B19 vaccine is currently being tested and may become available in the very near future.

Treatment for complications from erythema infectiosum.
Pregnant women and people with weakened immune systems or blood problems, such as sickle cell disease or thalassemia, are at an increased risk of developing complications from fifth disease.

Treatment for people who have or have a weakened immune system.

People who have blood disorders that cause anemia (such as sickle cell disease or thalassemia) may need a blood transfusion if the condition worsens rapidly (short-term aplastic anemia). To prevent chronic parvovirus B19 infection and profound anemia, immunoglobulin may be given intravenously to people with weakened immune systems.

Erythema infectiosum is sometimes referred to as the "fifth disease" as it can be considered an "addition" to the well-known TORCH infections, rubella, and toxoplasmosis.

Infectious erythema is a disease caused by the B19 paravirus. It affects people of all ages, but most often 4-11 year old children get sick. In adults, this form of erythema is relatively rare, but can be more severe, especially in women over the age of 30-35 years.

The viral variety of erythema during pregnancy is very dangerous, infection can lead to fetal death and miscarriage. Infection of a pregnant woman during the period from 10 to 26 weeks of pregnancy is especially dangerous for the fetus.

Causes of the disease

The causes of the development of infectious erythema have not been sufficiently studied, although it is known for certain that the disease is caused by the B19 (B19V) paravirus and, as a result of this virus, and can appear.

The infection is transmitted mainly by airborne droplets, however, its contagiousness (susceptibility to infection) is low. There are other ways of transmitting the infection, the virus can enter the body through a blood transfusion from an infected person, and infection of the fetus occurs through the placenta.

Parovirus B19, which causes the development of infectious erythema, is a single-stranded, non-enveloped DNA virus, its diameter is 18-24 nm.

Erythema infectious, as a rule, is manifested by sporadic outbreaks in children's institutions or families. After a disease, a person develops a stable lifelong immunity.

It must be said that when conducting serological studies during outbreaks of the viral form of erythema, it is shown that approximately 80% of those examined suffer from the disease in a subclinical (asymptomatic) form.

Clinical picture of the disease

The incubation period of this type of erythema lasts about two weeks. Symptoms and manifestations of the infectious form of erythema are highly dependent on subjective factors:

• The age of the patient;
• The presence of concomitant diseases;
• The presence of pathologies in the hematopoietic and circulatory system, etc.

The very first symptoms of infectious erythema resemble those of the flu. The patient has fever, itching in the nose, runny nose, sore throat and sore throat, chills, headaches, general weakness, lack of appetite. Sometimes these manifestations are so insignificant that the patient does not pay much attention to them.

A rash appears on the body a few days after the onset of the disease. Although this symptom may be absent, the absence of a rash is especially common in adult patients.

As a rule, a rash with infectious erythema appears on the body according to a certain scenario.

It all starts with the eruptive phase of erythema, when a rash appears on the face. As a rule, the cheeks first turn red, covered with roseolous or roseolous-papular elements, as with. The affected skin turns bright red and the outwardly sick infectious form of erythema at this stage of the disease looks as if he had been struck on the cheeks. The affected skin is edematous, the individual elements of the rash are initially quite large (diameter 1 cm or more). The elements of the rash in the infectious form of erythema grow rapidly and merge into continuous plaques, which are symmetrically located on the cheeks. The skin of the forehead and chin with this disease is extremely rarely affected. The rashes last 4-5 days, after which they resolve spontaneously.

The reticular phase of erythema infectiosum occurs about 2-3 days after the onset of the rash on the face. Sometimes both phases of erythema occur simultaneously. During this phase, rashes appear on the skin of the limbs, buttocks and trunk, resembling a mesh or fancy lace. Subjective sensations (pain, itching) do not occur with erythema. The rash disappears 6-14 days after the appearance.

In the future, with infectious erythema, a relapse phase begins, which can last 2-3 weeks. This phase of erythema is characterized by the occurrence of repeated rashes in the same areas of the skin. Stress, temperature changes, overheating or hypothermia can provoke the appearance of a secondary rash.

A rash with an infectious form of erythema is resolved without leaving marks in the form of peeling or pigmentation or. Sometimes patients have lymphopenia or mild lymphocytosis.

Articular syndrome

The next stage of infectious erythema is characterized by the development of symmetrical polyarthritis of moderately severe course. Symptoms at this stage of the disease are similar to those of rheumatoid arthritis.

Joint damage in erythema begins to appear with the onset of production of IgG and immune complexes in the body, which cause damage to the tissues of the joints. Polyarthritis can last from 2-4 weeks to 3-4 years, in some cases, joint lesions are migratory.

With infectious erythema in children, the articular syndrome is most often manifested by acute arthritis with a short course, in some cases, the articular syndrome is manifested exclusively by arthralgia (the appearance of pain in the joints without tissue damage). In children, only the knee joints are affected in about 80% of cases.

The duration of this phase of infectious erythema is 3-4 months, sometimes it can last for a year. Such a long course of articular syndrome often leads to an incorrect diagnosis - juvenile rheumatoid arthritis.

To exclude errors, it is necessary to assign laboratory tests. With infectious erythema, laboratory parameters remain within the normal range.

Infection during pregnancy

As already noted, infection with paravirus B19 is especially dangerous during pregnancy. Infectious erythema in a pregnant woman leads to infection of the fetus and the development of severe anemia, heart failure and generalized edema, which can lead to intrauterine death. In about 10% of cases, infection with paravirus B19 leads to spontaneous abortion.

Possible Complications

Infectious erythema can provoke the development of complications, especially often they occur in children.

This type of erythema can cause a suspension of red blood cell synthesis. If a person was initially healthy, then such a complication, in most cases, is imperceptible. However, if before infection there were problems with the blood system (for example, thalassemia, sickle cell anemia), then the cessation of erythrocyte synthesis can lead to an aplastic crisis lasting 7-10 days.

The infectious variety of erythema is difficult to tolerate in patients with aplastic anemia. In this case, patients have a rapid heartbeat, severe attacks of fever and other extremely unpleasant symptoms.

Infectious erythema is also dangerous for people with immunodeficiency. In such patients, the disease often becomes chronic, which ultimately leads to the development of severe pathologies of the hematopoietic system and persistent anemia.

Diagnostic methods

Clinical and laboratory diagnosis of the infectious form of erythema is a very difficult task, since the symptoms of the disease are similar to those of many other diseases.

On external examination, infectious erythema should be suspected by the typical, "lacy" appearance of the rash.

To make a correct diagnosis, it is necessary to translate a number of tests, in particular:

• Serological examination to detect antibodies to the virus.
• Carrying out a general analysis to detect the level of red blood cells, platelets and white blood cells in the blood.

A complete blood count should also be performed during treatment so that the effectiveness of the therapy can be assessed.

A differentiated diagnosis is required with diseases such as:

• Rubella;
• Medicinal toxidermia and;

When fields appear in the joints, it is necessary to distinguish the infectious form of erythema from:

• Rheumatoid arthritis and the appearance with it;
• Borrelios.

Treatment by methods of official medicine

With infective erythema in children and adults, hospitalization is usually not required. The principle of treatment of this disease is similar to the scheme adopted for the treatment of any other viral infections.

1. At the time of the febrile state with infectious erythema, bed rest is indicated.
2. It is necessary to take a large amount of liquid.
3. Antiviral drugs and drugs are prescribed to alleviate the symptoms of the disease.
4. The appearance of the second and subsequent waves of the rash is not an indicator of the severity of the disease; with infectious erythema, this is simply a characteristic feature of the disease.
5. During the treatment of erythema, exposure to the open sun or in a solarium should be excluded, hot baths should be limited.
6. Since erythema infectiosum is a viral disease, antibiotics are not prescribed for its treatment. However, antibiotic therapy may be required if microbial complications, pneumonia, tonsillitis, or otitis media have joined the erythema.

Treatment during pregnancy

Since infectious erythema poses a certain danger to the fetus, sick pregnant women are placed in a hospital for the duration of treatment. Therapy is carried out with constant monitoring of laboratory blood parameters and regular ultrasound of the fetus.

Hospitalization for the treatment of infectious erythema is also indicated for patients with immunodeficiency and diseases of the hematopoietic system.

Treatment with traditional medicine

As an addition to the treatment of infectious erythema selected by the doctor, herbal medicine methods can be used.

With this form of erythema, it is useful to use a tincture made from Rhodiola rosea, Schisandra chinensis or ginseng. You need to take any of these plants and grind it into powder if the raw material is dry, or into gruel if the grass is fresh. The prepared raw materials are poured with high-quality vodka, for 1 part of the grass you need to take 10 parts of vodka. Insist in a dark place for two weeks. Take, after straining, 20 drops three times a day before meals.

For the treatment of infectious erythema, you can prepare an infusion of the following medicinal plants: willow bark, birch leaves, black elderberry flowers. All components are mixed in equal parts. Then, one tablespoon of the prepared dry collection is taken per glass of boiling water and simmered at the weakest boil (preferably in a water bath) for five minutes. Then turn off the heating, cover the dishes with a lid and stand until completely cooled. Strain off the liquid, divide it into three portions. Take during the day before meals.

According to a similar scheme, you can prepare an infusion of knotweed herb, golden rod and succession. This infusion helps to quickly cope with infectious erythema.

Prevention and prognosis

The prognosis for infectious erythema is favorable. The patient from the moment the flu-like symptoms appear is subject to isolation, but after the appearance of the rash does not pose a danger to others. Therefore, with normal health with infectious erythema, you can lead a normal life.

Unfortunately, it is possible to become infected with infectious erythema from a carrier of the virus or from a patient in whom the disease is asymptomatic. Such people cannot be recognized, so effective prevention measures do not exist. However, you can reduce the risk of getting an infection. For this it is recommended:

1. If possible, exclude contact with people who have signs of a viral disease (runny nose, cough, etc.).
2. Wash your hands as often as possible, especially after returning from the street.
3. In no case do not use other people's things - handkerchiefs, cups, cutlery. Such basic hygiene rules will help reduce the risk of contracting erythema infectiosum.

Currently, active development of a vaccine aimed at protecting the body against paravirus B19 is underway. So, it is possible that soon doctors will offer to be vaccinated against erythema infectiosum.

Infectious erythema often referred to as the fifth disease because it is the fifth of the six common childhood viral exanthems described.
Erythema infectiosum (IE) is common throughout the world. Most patients become infected during their school years.
Infectious (IE) is an acutely contagious disease that spreads by air and most often develops in late winter - early summer. Some populations experience cyclic local epidemics every 4-10 years.

30-40% of pregnant women lack levels of IgG antibodies to the infectious agent, so they are considered susceptible to this disease. Infection during pregnancy can in some cases lead to fetal death.
Erythema infectiosum (IE) is a mild viral febrile infection associated with a rash. The causative agent of the infection is parvovirus B19.

Most individuals infected with parvovirus B19 do not develop clinical IE.
Parvovirus B 19 infects rapidly dividing cells and is cytotoxic to human erythrocyte precursor cells.

After primary infection, viremia develops in combination with a sharp drop in the number of reticulocytes and anemia. In healthy patients, anemia rarely presents clinically, but it can become a serious problem if the number of red blood cells was low before the disease. Patients with chronic anemia, such as sickle cell anemia or thalassemia, may experience a transient aplastic crisis.

If a woman becomes infected during pregnancy, vertical transmission can lead to congenital infection. The risk of fetal loss or fetal hydrops is highest (fetal loss rate 11%) if infection occurs during the first 20 weeks of pregnancy.

For fifth disease characteristic is a classic erythematous rash on the cheeks in children against the background of the comparative pallor of the surrounding skin - a picture of "slapped cheeks", as well as "lace" erythematous rashes on the trunk and limbs. Before the onset of skin rashes, children and adults may experience specific flu-like symptoms for 4 or more days. In adults, the rash may be preceded by arthropathy of the hands, wrists, knees, and ankles. The disease usually resolves on its own.

rashes start with the classic slapped cheek pattern. Then an erythematous patchy rash appears on the extremities. After a few days, the rashes on the extremities turn pale, forming a "lace" pattern. Exanthema may recur within weeks after exercise, sun exposure, hot water bathing, or stress.

Laboratory research usually not required if diagnosis is based on history and clinical examination. In pregnant women who have been at risk of infection, the presence of B19-specific serum IgM antibodies is sometimes determined. The presence of infection is indicated by a four-fold or greater increase in titers of B19-specific serum IgG antibodies after 3 weeks.

At patients those with symptoms of anemia and a history of increased red blood cell destruction (eg, sickle cell anemia, hereditary spherocytosis) or reduced production of red blood cells (eg, iron deficiency anemia) should be treated for anemia.

Differential diagnosis of infectious erythema

Acute rheumatic fever presents as a fine papular (sandpaper-like) rash associated with a streptococcal infection.
An allergic hypersensitivity reaction is manifested by vasculitic rashes.
Lyme disease is characterized by spreading lesions with central resolution.

Treatment of infective erythema

IE (fifth disease) usually resolves on its own and does not require specific therapy.
Non-steroidal anti-inflammatory drugs and acetaminophen may relieve symptoms of fever and arthralgia.
Transient aplastic anemia can be severe enough to require a blood transfusion until the patient's red blood cell production is restored.
Pregnant women who are at risk of infection or who have symptoms of parvovirus infection should undergo serological testing. Women who test positive for an acute infection before 20 weeks of gestation (eg, positive for IgM and negative for IgG) should be advised of the low risk of fetal loss and congenital anomalies. With positive test results, some experts recommend performing an ultrasound scan to look for signs of fetal hydrops. Intrauterine blood transfusion is the only effective way to treat fetal anemia.

Recommendations for patients with infectious erythema:
Parents should be made aware that the disease typically resolves on its own. The patient can continue with normal activities, while avoiding sun exposure.
When the classic signs of IE appear, children are no longer contagious and can attend school/kindergarten.
Women who have had an acute infection before 20 weeks of gestation should be aware of the low risk of fetal loss and the development of congenital anomalies. After the 20th week of pregnancy, some doctors recommend repeated ultrasound examinations to look for signs of fetal dropsy.

Clinical example of erythema infectiosum. A 2-year-old boy is brought to the doctor with mild flu-like symptoms and a rash. The child has erythematous rashes on the cheeks and a "lacy" erythematous rash on the trunk and extremities. The picture of "slapped cheeks" easily makes it possible to establish the diagnosis of the fifth disease. Parents were reassured, explaining that the disease would resolve itself. The child was discharged the next day for outpatient follow-up.