From the Research
Fifth disease has several dangerous mimics that require immediate medical attention, including measles, rubella, scarlet fever, Kawasaki disease, meningococcal disease, and certain drug reactions, which can be distinguished by additional symptoms such as high fever, respiratory symptoms, or systemic illness. Fifth disease, caused by parvovirus B19, typically presents with a characteristic "slapped cheek" rash and lacy rash on the body 1. The diagnosis of fifth disease is mainly clinical, and physicians should be well-versed in the clinical manifestations of erythema infectiosum to avoid misdiagnosis, unnecessary investigations, and mismanagement of the disease.
Key Points to Consider
- Dangerous mimics of fifth disease may initially present with similar rash patterns but often have additional distinguishing symptoms like high fever, respiratory symptoms, or systemic illness.
- If a rash is accompanied by high fever, difficulty breathing, altered mental status, severe headache, stiff neck, or appears unusually purple or bruise-like, immediate medical evaluation is necessary.
- The distinction between fifth disease and its mimics matters because while fifth disease is usually mild and self-limiting in healthy individuals, these mimics may require specific treatments like antibiotics for bacterial infections or immunoglobulin therapy for Kawasaki disease to prevent serious complications.
Conditions that Mimic Fifth Disease
- Measles: can cause severe complications like pneumonia and encephalitis
- Rubella: particularly dangerous for pregnant women
- Scarlet fever: caused by streptococcal bacteria requiring antibiotic treatment
- Kawasaki disease: can lead to heart complications if untreated
- Meningococcal disease: a medical emergency that can cause sepsis
- Certain drug reactions: can cause severe skin and systemic reactions It is essential to note that the most recent and highest quality study 1 provides a comprehensive overview of erythema infectiosum, highlighting the importance of clinical diagnosis and awareness of potential complications and conditions associated with parvovirus B19 infection.