Erythema Infectiosum Treatment & Management

Updated: Mar 06, 2020
  • Author: Glenn L Zellman, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Approach Considerations

Because erythema infectiosum most often is a benign, self-limited disease, reassuring the parents of children with the condition often is the only intervention necessary. [8] For patients with arthralgias or pruritus, symptomatic relief can be obtained using oral analgesics and antihistamines or topical antipruritic lotions.

Activity

Activities may be pursued as tolerated, with sun protection or avoidance.

Referrals and consultations

The following referrals are made for patients with erythema infectiosum:

  • Dermatologist - Refer patients for diagnosis and dermatologic care

  • Internal medicine specialist - Refer patients for associated conditions

  • Obstetrician/gynecologist - Due to potential complications from intrauterine human parvovirus (PV) B19 infection, refer pregnant women who have IgM antibodies to PV-B19 or who have been exposed to the virus

Consider consultation with a hematologist and/or oncologist for patients in aplastic crisis.

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Inpatient Care

Most children with aplastic crisis require hospitalization and probable transfusion and/or intravenous immunoglobulin therapy.

Hospitalized patients with erythema infectiosum need no special isolation precautions; however, patients with aplastic crisis or immunosuppression with human PV-B19 infection should be isolated.

Pregnant health-care workers should be informed of the potential risks to the fetus from PV-B19 infections. They should not be involved in treatment of immunocompromised patients with chronic parvovirus infection or patients with human PV-B19–associated aplastic crisis.

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Monitoring

Children with erythema infectiosum are not infectious and may attend child care or school.

Pregnant women in contact with patients in the incubation period of erythema infectiosum or with aplastic crisis have a relatively low potential risk of infection. They can be referred for obstetric follow-up care for possible serologic testing and close fetal monitoring.

Routine exclusion of pregnant women from the workplace where erythema infectiosum is occurring is not recommended, due to the high prevalence of human PV-B19 infection and low incidence of fetal effects.

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Prevention

Because children with erythema infectiosum are contagious prior to the onset of the classic-appearing rash, preventing the spread of this common childhood exanthem is difficult. Attentive parents can only give their children the general good advice to frequently wash their hands and to avoid the sneezes, coughs, and discarded tissues of children who appear sick.

Public health and infection control

Since children with erythema infectiosum are contagious only during the asymptomatic viremic period (occurring approximately 1 wk before the rash appears), restricting them from attending school is not necessary by the time the clinical diagnosis is made. [51]

Patients with PV-B19–induced aplastic crisis or chronic anemia may be actively viremic during the illness. Patients require routine respiratory isolation, since the virus can be spread via aerosolized respiratory droplets.

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