Erythema Infectiosum (Fifth Diseas, Infectious Erythema, EI)

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Erythema Infectiosum
Body Parts: Whole Body
Medical Subjects: Children's Health Skin Infectious Disease
Overview

What Is Erythema Infectiosum?

What is infectious erythema?

Erythema infectiosum, or EI for short, is an exanthematous disease caused by human parvovirus B19 infection, which is characterized by rosy erythema with clear borders on both cheeks.

It is one of the six common skin rashes in children, which are named in the chronological order in which they were first reported, and infectious erythema is ranked fifth, hence it is also called Fifth Diseas.

At present, there is no specific medicine for it. People with normal immune function will recover from infection and the prognosis of most children is good.

Is infectious erythema common?

Infectious erythema often breaks out in school-age children and occasionally in adults. It can happen all year round, with peak in winter and spring.

It often occurs among children between the ages of 4 and 12. It is extremely rare for a pregnant woman to have a fifth disease which can be dangerous to the fetus.

Studies have found that the detection rate of antibody increases with age. The proportion of serum B19 antibody in children under 5 years old is about 5%–10%, while in adults it is about 40%–60%. This means that about 40% to 60% of people will experience a B19 infection. Infectious erythema is a common manifestation of B19 infection.

Approximately 25% of infected individuals are completely asymptomatic during the infection period, while 50% of infected individuals have only flu-like symptoms such as malaise, myalgia, and fever, with the remaining 25% experiencing infectious erythema and/or arthralgia.

Are contagious dermatitis and erythema infectiosum the same disease?

Infectious erythema and contagious dermatitis are two different diseases, the former is caused by viral infection, and the latter is fungal infection.

Contagious dermatitis, also known as Dermatophilosis, is a skin disease caused by dermatophilia in the Congo, which mainly comes from diseased animals.

Two to seven days after human skin injury (such as long-term immersion, scratching, abrasion, insect bites, and so on) and contact with animals with dermatophytosis, multiple painless pustules appeared on the skin of the back of hand and arm, about 2 to 5 mm, and a shallow small red ulcer was left after the ulceration, with the edge bulged like a crater, and finally a brown scab appeared, which fell off after about 1 week, leaving a purplish red scar. The whole course of disease lasts for about 14 days.

Cause

What Is The Cause Of Erythema Infectiosum?

What are the common causes of infectious erythema?

At present, B19 virus is considered as the cause of infectious erythema.

Who is susceptible to infectious erythema?

Infectious erythema often erupts among school-age children, most of whom are children aged 4 ~ 12 years old, but also occasionally in adults.

Is infectious erythema contagious? How is it contagious?

Infectious erythema is not very contagious, but patients with temporary aplastic crisis are highly contagious.

B19 virus is contagious within 5 ~ 10 days after exposure, and lasts about 5 days. During this period, the patient may be asymptomatic or have flu-like symptoms.

Subsequently, the body of patients with normal immune function produces antibodies to the virus, and at this time, specific symptoms or signs may appear, such as joint pain, arthritis and/or rash.

When patients have these clinical features, they are no longer contagious.

Some immunocompromised patients may be infected and contagious for a long time after being infected with B19 virus. However, there is no correlation in this respect at present.

Symptom

What Are The Symptoms Of Erythema Infectiosum?

What are the common manifestations of infectious erythema?

Prodromal symptoms are mild and may include low grade fever, headache, and upper respiratory tract infections such as sore throat, cough, sneezing, and muscle soreness.

After these symptoms last for 2 to 5 days, rash and/or joint pain may occur:

The typical presentation during the erupting period is the first rash on the cheek, which pales in comparison to the perioral appearance. The rash can develop rapidly on the trunk and limbs, and has a lacy, reticular erythematous appearance. There is less rash on the trunk, palms, and toes.

A typical rash resolves within about a week, but can also occur intermittently over several weeks, especially when stress, exercise, sun exposure, bathing, or changes in environmental humidity occur.

Which part can appear infectious erythema?

Infectious erythema occurs frequently on the face and can also occur in the trunk and limbs, with arthralgia occurring in only about 10% of children with infectious erythema. Patients with arthralgia usually get relief in about 2 to 4 weeks, and some patients can continue for several months.

What serious consequences can infectious erythema cause?

A small number of patients may present hematological abnormalities, including reticulocyte reduction, decreased hemoglobin concentration, leukopenia, and/or thrombocytopenia. Very few patients with underlying hematological abnormalities, such as sickle cell anemia or thalassemia, may develop life-threatening anemia and require urgent transfusion therapy.

Very few people infected with B19 virus may also cause myocardial damage, which can be fatal in severe cases.

In immunocompromised patients, viremia may not be cleared, and chronic infection occurs with persistent effects on the red blood cell system and chronic severe anemia. In addition, chronic infection prone to systemic necrotizing vasculitis.

Detect

How To Check For Erythema Infectiosum?

How to confirm the infectious erythema?

When doctors diagnose infectious erythema, the diagnosis can be made mainly based on the patient's performance, medical history and typical symptoms, and further confirmation by pathogen detection is generally not required.

What tests are needed to confirm the diagnosis of infectious erythema?

For patients who are in good health at ordinary times and have no abnormal basic blood system or abnormal immune function, laboratory tests are generally not required.

Routine blood tests and reticulocyte counts are required in patients with previous underlying hematological or immunologic abnormalities. For patients with severe disease and clinicians considering the need to identify the pathogen, blood tests for IgM and IgG antibodies to B19 virus should be conducted.

A definite diagnosis can be made if there is a corresponding clinical presentation and IgM antibodies are also positive.

IgG antibodies generally indicate a past infection unless a duplicate serum test confirms a more than 4-fold increase in antibody titer in the second serum, indicating a present infection.

Serum antibody testing is often ineffective in immunodeficient patients and viruses and DNA can be detected by PCR and nucleic acid hybridization. However, after B19 infection, the available viral DNA in blood can last for 80 to 100 weeks, so the test results should be carefully analyzed in combination with clinical practice.

Is there anything that needs to be noticed before checking for infectious erythema?

IgM antibody, IgG antibody, PCR, and nucleic acid tests, all of which are not specifically required, and whether or not they were fed did not affect their accuracy.

Which diseases are easily confused with infectious erythema? How to distinguish them?

The differential diagnosis of B19 virus infection depends primarily on clinical presentation.

The primary differential diagnosis of infectious erythema includes other infectious rash such as infantile rash, rubella, measles, enterovirus infection, and Group A streptococcal infection.

The nature and distribution of the rash, as well as vaccination history and the presence or absence of other symptoms, can help distinguish these infections.

Acute rheumatoid arthritis should also be distinguished in patients with pain. In addition to specific examinations for rheumatoid arthritis and follow-up, symptoms of rheumatoid arthritis usually do not resolve after a few weeks, while symptoms of B19-infected joints usually resolve spontaneously after a few weeks.

The specific identification should be judged by the doctor.

Prevention

How To Prevent Erythema Infectiosum?

Can infectious erythema be prevented? How to prevent?

Infectious erythema can be prevented by paying attention to hand hygiene at ordinary times, frequently washing hands, less touching the face, eyes, mouth and nose, less going to places with a large population, especially in winter and spring when diseases are at a high incidence, and reducing the chance of contacting the sick. Also, don't share food, drinks, and cutlery with others.

How to prevent the recurrence of infectious erythema after treatment?

Infectious erythema virus infection after the body there will be related antibodies, you can protect the body from re-infection, generally does not relapse.

How to reduce the influence of infectious erythema to patient body?

At present, there is no good medical method to prevent the occurrence of complications of E infectious erythema. Patients try to have a good rest, diet to ensure nutrition, in order to maintain a good immune state, to fight the virus.

Treatment

How To Treat Erythema Infectiosum?

What clinic should patients with infectious erythema visit?

If it is a child, go to the pediatrics department. If you are an adult, please go to the internal medicine or dermatology department. Some hospitals will have special infection department and preventive care department, is also ok.

Can infectious erythema heal itself?

Yes, infectious erythema is usually self-healing, there is no specific.

How to treat infectious erythema?

Infectious erythema usually does not require special treatment and can self-heal. If patients have uncomfortable symptoms, symptomatic treatment is given, for example, when fever is untimely or joint pain is untimely, oral ibuprofen or acetaminophen is given to relieve the discomfort. If the rash is itchy, apply calamine lotion externally.

For patients with complications, such as severe anemia, give blood transfusion, myocardial damage, give the corresponding symptomatic support treatment.

Does infectious erythema need to be hospitalized?

Patients with common infectious erythema do not need hospitalization, while patients with severe complications, such as severe hematological or myocardial damage, need hospitalization and observation of disease changes.

What are the common adverse reactions of the treatment of infectious erythema?

Infectious erythema no specific, if it is mild, generally do not need medication.

And if accompanied by fever or joint pain discomfort, then the use of antipyretic analgesics, such as acetaminophen or ibuprofen, the common adverse reactions are gastrointestinal discomfort, mild decline in hemoglobin, liver damage, etc. As for the calamine lotion used for relieving skin itching, generally there is no adverse reaction, or skin allergy is rare, and the drug can be stopped in time.

Can infectious erythema effect a radical cure?

The vast majority of patients will heal themselves. Unless it is a previously immunodeficient patient, viremia may not clear and a chronic infection develops.

Life

What Should Patients With Erythema Infectiosum Pay Attention To In Life?

What should patients with infectious erythema pay attention to in their diet?

As usual diet, hun vegetable collocation is appropriate to balanced nutrition. Avoid eating foods that you have not eaten at ordinary times or foods that you have been allergic to in the past, so as to avoid aggravation of the rash. It is not good to judge whether there are any allergic factors.

What should patients with infectious erythema pay attention to in their lives?

In theory, at the early stage of infection, we should pay attention to isolation at home, wear masks and wash hands frequently to avoid contact with pregnant women and people with immune defects or blood system diseases, so as to avoid passing the virus to them and causing serious cases.

However, in fact, many people are diagnosed only after the rash symptoms appear, and at this time it is no longer contagious.

If you have fever, pay attention to rest, drinking water. If there is joint pain, pay attention to avoid too much activity.

Do patients with infectious erythema need isolation?

Infectious erythema needs isolation in the viremic phase, when rash symptoms do not appear, but the etiology is often unclear at this time.

Later, most studies believe that in the presence of symptoms such as rash, no virus in the blood, that is, viremia has subsided, and therefore it is no longer considered infectious at this time, so it is generally not necessary to isolate at this time.

Does infectious erythema need reexamination?

Patients with normal immune function do not require follow-up.

High-risk patients with arthritis or previous immune dysfunction or hematological disorders require inpatient or outpatient follow-up at the discretion of the attending physician.

Will patients with infectious erythema affect pregnant women who have been exposed?

Patients who have developed skin rash are generally not contagious and can be contacted.

However, if pregnant women have contact within 15 days before the rash of patients with infectious erythema, they need to worry about the possibility of cross-infection, pay close attention to whether there is a corresponding symptom, generally observe for about half a month, and timely visit a doctor to assess the situation of the fetus when necessary.

What should a pregnant woman with infectious erythema do?

There is currently no definitive evidence that B19 causes congenital abnormalities, but there is a risk of miscarriage.

For pregnant women infected with B19 virus, no medication recommendation is available, but regular follow-up visits should be conducted to assess the condition of the fetus, and if abnormalities of the fetus (such as edema) are found, the fetus should be delivered in a medical institution with neonatal intensive care conditions to ensure better medical conditions for the treatment of infected neonates.

Intrauterine blood transfusion to improve fetal survival should also be considered if severe fetal anemia is assessed during pregnancy.

How should family members care for patients with infectious erythema?

Take care to ensure that they have adequate rest and a balanced diet to fight the virus.

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