From the Guidelines
Fifth disease, also known as erythema infectiosum or parvovirus B19 infection, typically requires only supportive treatment as it usually resolves on its own within 1-3 weeks. The provided evidence 1 does not directly address the treatment of fifth disease, but rather focuses on the treatment of Lyme disease. However, based on general medical knowledge, the treatment for fifth disease is primarily supportive.
Key Considerations
- For symptom relief, acetaminophen (Tylenol) at 325-650 mg every 4-6 hours or ibuprofen (Advil, Motrin) at 200-400 mg every 4-6 hours can help manage fever and joint pain.
- Rest and adequate fluid intake are essential for recovery.
- Apply cool compresses to the characteristic "slapped cheek" rash if it causes discomfort.
- For severe joint pain, which is more common in adults, anti-inflammatory medications like naproxen (220-440 mg twice daily) may provide additional relief.
Special Populations
- In rare cases where symptoms are severe or prolonged, especially in immunocompromised individuals or pregnant women, medical attention should be sought immediately.
- Pregnant women exposed to the virus should contact their healthcare provider, as there is a small risk of complications for the fetus.
Outcome
Most healthy individuals recover completely without specific antiviral treatment, as the body naturally clears the infection.
Morbidity, Mortality, and Quality of Life
The primary goal is to manage symptoms and prevent complications, particularly in high-risk populations, to minimize morbidity and mortality and improve quality of life.
From the Research
Treatment of 5th Disease
- The treatment of 5th disease, also known as erythema infectiosum, is mainly symptomatic and supportive 2.
- In most cases, the condition is self-limited and resolves spontaneously within three weeks without sequelae 3, 2.
- Treatment may include relief of symptoms such as fever, headache, and malaise 2.
- In some cases, especially in adults, treatment may involve management of complications such as arthritis, arthralgia, and transient aplastic crisis 2.
- A retrospective case report suggests that conservative management, including spinal manipulation, peripheral joint mobilization, acupuncture, and physiotherapy, may be considered as an adjunctive therapy option for adults with erythema infectiosum 4.
- However, further validation and research is warranted to support the use of conservative management for this condition 4.
Management of Symptoms
- Symptomatic treatment may include the use of antipyretics and analgesics to relieve fever and pain 2.
- In some cases, treatment may involve the use of topical steroids or antihistamines to relieve itching and reduce inflammation 5.
- Patients with erythema infectiosum should be advised to rest, stay hydrated, and avoid strenuous activities until symptoms resolve 2.
Special Considerations
- In pregnant women, parvovirus B19 infection can cause hydrops fetalis, and therefore, close monitoring and management are necessary 2.
- Individuals who are immunocompromised, chronically anemic, or pregnant should be aware of the potential complications and conditions associated with parvovirus B19 infection 2.