Viral rash? or child abuse?

I just saw a rash this morning while teaching medical residents.  Have you heard of “fifths disease?”  I saw a slap-cheeked looking kid, at little risk of being abused.  The offending virus is Parvovirus B19.  Interesting questions were brought up.  The mom of this patient  is pregnant.  So, that unleashes a “can of worms.” 

There are significant risk factors for that mother as parvovirus can cause fetal death (rare, but possible).  We will follow blood work on the mother (parvovirus IgM and IgG) to see if she has been exposed to this virus before or if this is a “new-sighting” and therefore is more dangerous to the fetus.

For the most part, no rash (or viral) treatment needed.  The slapped-cheek look resolves spontaneously.  Some have joint pain  or mild fever both symptoms can be treated with non-steroidal anti-inflammatory pills (like ibuprofen).

For patients with sickle-cell disease or autoimmune diseases, parvovirus can cause severe blood breakdown, requiring transfusions.

We are unsure of the mode of transmission (saliva?  fomite?).  We know that parvovirus passes through a household fast, but may make its way through a school over several months.  Advice: Avoid contact with sick people.  Cover your cough.  Wash your hands!

Hope this helps.

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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