00:01 Now let's cover erythema infectiosum which is fifth disease. 00:05 A long time ago, fifth disease got its name because it was the fifth on the list of six commonly recognized childhood rash forming illnesses. 00:13 And this is caused by an infection with the parvovirus B19. 00:17 The incubation is 4 to 21 days and it's found more commonly in the spring. 00:21 It's transmitted via respiratory secretions, including cough, saliva and sputum or contact with infected blood. 00:29 Now, this can also be transmitted vertically in pregnancy. 00:34 Usually this affects school-age children, daycare workers, teachers and parents. 00:39 It's most infectious prior to and during the initial onset of symptoms. 00:44 But once the rash appears, they're no longer contagious so no isolation is necessary. 00:49 Let's talk about the parvovirus B19. 00:52 This is gonna cause a transient suppression of erythropoiesis. 00:55 It's usually mild and asymptomatic. 00:58 These immunocompromised children can develop a protracted viremia though for weeks to months. 01:04 Typically in the healthy population you won't see this. 01:07 Patients with hemoglobinopathy is like sickle cell disease, can develop an aplastic crisis if they get parvovirus B19. 01:14 And it's usually self-limiting and usually mild. There's phase 1. 01:20 This is where the patient gets sick. 01:22 They have a low-grade fever, a headache, a rash and cold like symptoms. 01:26 This is pretty low on a parent's radar. 01:29 Next, the child will develop a rash and this is phase 2, a few days later. 01:34 They're gonna start with a bright red rash on their cheeks. 01:37 It's described as a slap cheek look and it is classic. 01:41 They'll also develop a red lacy rash on the rest of their body. 01:44 And once this rash develops, the child is no longer contagious. 01:48 The rash can wane and wax and temporarily reappear during this phase. 01:53 Adolescents and adults can get a self-limited arthritis. 01:57 So when you're examining a patient that you suspect might have fifth disease, you're gonna collect a medical history. 02:03 You're also going to review the child's immunization status and this is to exclude other causes of fever and rash. 02:10 Your gonna do a physical exam, including, looking at the vital signs, a complete, head, eyes, ears, nose, throat exam. 02:18 You're gonna do a cardiac, respiratory and full skin exam. 02:23 So how do we diagnose fifth disease? This is a clinical diagnosis which means you use your history and your physical exam to drive your diagnostics. 02:33 There is no lab work or testing needed especially in children. 02:36 But you'll do this if a child has a known blood disorder or an impaired immune system because these are the children at risk for complications. 02:45 Fifth disease is a self-limiting viral infection. Antibiotics are not effective because remember, this is a virus. 02:52 Most children are gonna feel totally fine and be playing and running around when they have fifth disease. 02:58 You can do symptomatic care for their cold-like symptoms but it's usually not necessary. 03:03 A child can have acetaminophen for their fever or joint pain if they need it. 03:08 The rash may be itchy so you want to avoid hot showers and hot baths because this can make an itchy rash even worse. 03:14 And remember, no aspirin in the pediatric population because this can cause Reye's syndrome. 03:19 And this is a rare but serious condition that causes swelling in the liver and brain. 03:24 So what are the complications? Well, typically in healthy children, there won't be any complications. 03:29 They're just gonna have a very mild illness. In the pregnant population, this can be very serious. 03:35 It can be linked to hydrops fetalis which can cause spontaneous abortion also known as a miscarriage. 03:42 In patients with sickle cell anemia, they can develop an aplastic crisis. 03:46 And in the immunocompromised patients, they can be at increased risk for complications.
The lecture Erythema Infectiosum – Fifth Disease (Pediatric Nursing) by Paula Ruedebusch is from the course Infectious Diseases – Pediatric Nursing.
What is the classic clinical indication of erythema infectiosum?
What is a complication of erythema infectiosum in children with sickle-cell anemia?
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