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Fifth Disease template



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Description of Fifth DiseaseA common viral infection characterized by an eruptive rash. Since it was the fifth disease described with an eruptive rash, it was named "fifth disease"
Risk Factors for Fifth DiseaseIncubation period is 4-28 days with average of 16 days Contact with a person before the rash erupts Nasal secretions and aerosolized respiratory droplets are means of transmission
Assessment Findings in Fifth DiseaseProdrome: Low-grade fever, malaise, sore throat, lethargy (1-4 days) Rash
Phases of Rash in Fifth DiseaseFirst Phase - Often appears first on cheeks of face: intense red rash with circumoral pallor; hence the name "slapped cheek disease" Second Phase - spreads to body and extremities over next few days: Macular and lacy appearing Final Phase - May be pruritic and itch more intensely with exercise, sun exposure, or bathing (can last up to 21 days) Palms and Soles may be affected (lasts 7-20 days) Children may return to school during rash phase Adults may have arthralgias and/or arthritis
Diagnostic Studies for Fifth DiseaseUsually none; diagnosis is made clinically B19 specific IgM (Confirms acute infection) B19 specific IgG (Confirms past infection)
Prevention of Fifth DiseaseAvoid exposure to persons with known infxn Danger to fetus is primarily severe anemia due to RBC destruction and aplasia Pregnant women should avoid close contact with aplastic Parvo B19 pts because they are highly contagious
Nonpharmacologic Management of Fifth DiseaseSupportive care Rest
Pharmacologic Management of Fifth DiseaseNo specific treatment Analgesics if needed
Pregnancy Considerations with Fifth DiseaseRash in pregnant women should be assessed for possible Parvo B19 infection Infxn during pregnancy is associated with a 10% fetal death There is no indication for abortion or routine exclusion in the work place if known infected personnel are present Fetal US and alpha-fetoprotein testing can help assess fetal damage if documented infxn and exposure has taken place
Expected Course of Fifth DiseaseRash may last up to 3 weeks Rash may fade, intensify depending of temperature, sunlight, exercise



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