Erythema infectiosum


Clinical Features

  • Initially mild URI-type symptoms
    • Malaise, myalgias, and headache 7-10 days prior to rash [1]
  • "Slapped cheeks" rash
    • Abrupt appearance on day 3-4
      • Spares eyelids and chin
    • Lasts 4-5 days
  • Macular erythema develops on trunk/limbs 2 days after appearance of facial rash
    • Distinctive aspect of rash: faces with central clearing, giving a reticulated or lacy appearance
    • May last 1 week
    • Rash may recur within 3 week period
  • Papulopurpuric glove-and-sock syndrome
  • Associated symptoms include fever, headache, sore throat, cough, coryza, nausea and vomiting
Fifths Disease

Differential Diagnosis

Pediatric Rash


  • Clinical diagnosis, based on history and physical exam


  • Symptomatic


  • Discharge most patients
    • Referral to maternal-fetal medicine specialist for infection in pregnancy
  • Admit if aplastic crisis


See Also


  1. Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
  2. Shirk A, Sorrentino A. Viral Exanthems. In: Schafermeyer R, Tenenbein M, Macias CG, Sharieff GQ, Yamamoto LG. eds. Strange and Schafermeyer's Pediatric Emergency Medicine, 4e. New York, NY: McGraw-Hill; 2015