Erythema infectiosum is a disease caused by paravirus B19. The pathology can affect people from different age categories, but children aged 4 to 11 years are more susceptible to it. In adults, erythema infectiosum occurs in extremely rare cases, but its course is more complex, especially in women aged 30–35 years. Also this pathology is very dangerous during pregnancy. Infection of the mother can lead to miscarriage. Infection is especially dangerous for a pregnant woman between 10 and 26 weeks.
Erythema infectiosum is often referred to as the “fifth disease.” The reason is that some scientists consider it an “addition” to the known TORCH infections - simple, .
Causes
The reasons for the progression of the fifth disease have not yet been fully studied, but what is certain is that the disease develops due to negative impact on the body of paravirus B19. Because of this, viral exanthems begin to form.
The infection spreads primarily through airborne droplets. It is worth noting that its contagiousness is not high. The virus can also enter the body during a blood transfusion (if the donor was infected). Infection of the fetus occurs transplacentally. Once a person has recovered from erythema infectiosum, they develop lifelong immunity.
Clinical forms of erythema infectiosum
- erythema infectiosum of Rosenberg;
- erythema infectiosum of Chamera;
- sudden exanthema;
- erythema nodosum;
- exudative erythema multiforme;
- undifferentiated erythema.
Symptoms
The symptoms of the disease directly depend on which particular form of fifth disease has begun to progress in a person. But it is worth noting that the symptoms are usually very pronounced, which causes significant discomfort to the patient. Treatment of pathology is best carried out only in inpatient conditions under close supervision medical specialists, but treatment at home can also be done.
Erythema infectiosum of Rosenberg
This form of the disease is characterized by acute onset. Severe fever appears and symptoms of intoxication increase. A spotted rash appears 4–6 days after the onset of pathology progression. The elements are localized on the buttocks and limbs. In these places they can form continuous erythematous fields. No rash elements appear on the skin of the face.
The rash completely disappears after 6 days. At the site where the lesions were localized, peeling is noted. Splenomegaly or hepatomegaly is sometimes noted. The fever lasts for 10–12 days. In rare clinical situations, patients experience joint swelling.
The incubation period for erythema infectiosum of Chamera lasts from 9 to 14 days. This form The disease is relatively mild. Most often it is diagnosed in children from various age groups. There is no fever - temperature readings are within normal limits. Elements of the rash appear already on the first day of illness. With erythema infectiosum in children, the rash is localized on the skin of the face. Gradually, the individual elements begin to merge and form the shape of a butterfly.
As the pathology progresses, individual elements of the rash may turn pale (usually starting from the center). But this does not mean that the disease is going away. Exanthema remains on the skin for up to two weeks. New elements can arise due to hypothermia, overheating, and physical exertion. Sometimes children have inflammatory diseases upper respiratory tract. In adult patients, swelling appears in the joint area.
Erythema nodosum
The disease develops against the background infectious pathologies, which are already present in the human body. Most often it affects adults. The symptoms of the pathology are pronounced. Body temperature rises sharply, pain in large joints of the lower extremities increases.
The rash is located symmetrically in the area of the forearms and legs. When palpated, dense nodular formations can be detected, the size of which does not exceed five centimeters. The skin above the nodule is discolored. At first it has a red tint, later it becomes cyanotic or greenish-yellow.
Polymorphic exudative form
Symptoms of intoxication are pronounced. The temperature rises to high numbers - 39–40 degrees. On days 4–6, a rash appears on the skin of the torso and limbs - spots or papules. Bubbles may also form, filled with exudate inside. They tend to open up on their own, forming erosion. Later it is covered with a brown crust.
Sudden exanthema
The latent period lasts up to five days. The onset of the disease is usually acute, with an increase in temperature to high numbers (up to 40 degrees). Symptoms of intoxication are moderate. The temperature returns to normal only on the 4th day. At the same time, elements of the rash appear, which are localized on the limbs, torso, and also on the skin of the face. Appearance elements - small spots of pale pink color. They tend to merge.
Undifferentiated form
This form of erythema is represented by a group of ailments of an infectious nature, the etiology of which is unknown or not fully understood. The disease is characterized by the appearance of fever. Symptoms of intoxication are not pronounced. A rash appears on the skin, which is not characteristic of any other infectious disease.
Diagnostics
The standard diagnostic plan for suspected erythema infectiosum includes:
- analysis of the medical history, as well as patient complaints;
- personal examination to identify the location of the rash, as well as assess the type of elements;
- carrying out polymerase chain reaction– PCR;
- linked immunosorbent assay;
- undergoing consultations with specialized specialists - a dermatologist, an infectious disease specialist.
Treatment
Treatment of patients with this type of erythema is usually carried out at home. Mostly children are hospitalized younger age, as well as those people who have severe course or complications have developed.
Specific treatment is usually not required, so the main therapy is aimed at eliminating unpleasant symptoms illness:
- antiallergic drugs;
- if there is a fever, antipyretic medications are prescribed;
- painkillers are indicated to be taken if available severe pain in the joints.
If the disease is severe, then the main course of treatment is supplemented with glucocorticosteroids. They are also used if the patient has severe somatic diseases, as well as immunodeficiencies.
Erythema infectiosum in children occurs between the ages of 5 and 10 years. Despite the frequency of its manifestation and the presence of a large number of photos on the Internet, allowing you to find out what it looks like, it is not always possible to diagnose the disease. The disease is easily confused with dermatitis, rubella, roseola and others, since the first symptoms are almost identical.
Viral can manifest itself as a separate disease or be part of symptomatic manifestations other diseases from the dermatological group. It is considered to be a combination of several types of viruses, which manifest themselves as redness in different areas of the skin.
Most often, erythema occurs in young children and newborns who have weak immunity, which does not allow them to provide adequate resistance to viral pathogens.
The disease has various clinical forms:
- Chemer's erythema is the most common form, caused by parvovirus B19;
- Leiner's annular erythema - pathogens streptococci;
- exudative erythema multiforme - it occurs during the development of infectious diseases in the body: tonsillitis, sinusitis, whooping cough and others;
- erythema nodosum - can manifest itself with the development of rheumatism, tuberculosis;
- exanthema - appears suddenly due to the development of herpes disease of various types;
- pink lichen of Zhiber;
- Rosenberg's erythema;
- streptoderma with ring-shaped erythema;
- toxic form of erythema.
In medicine, it is customary to distinguish another type of disease – physiological erythema. It is not considered a pathological phenomenon, since redness in children appears under the influence of external factors.
The manifestation makes itself felt in the first three days after the birth of the child. There is no need to treat physiological erythema - it disappears on its own without a trace within some time.
Causes of the disease
In newborns, the development of erythema is a fairly common phenomenon associated with low development immune system, which has not yet had time to fully form. In rare cases, infection can occur in the womb or during childbirth. In older children, the disease occurs for the following reasons:
- development of infections of bacterial or viral origin;
- in case of intoxication;
- the appearance of allergic reactions;
- other causes of unknown origin.
This infection occurs extremely rarely in adults, but if infection does occur, the erythema is much more difficult to tolerate.
If you suspect the development of this disease, immediately contact an infectious disease specialist to diagnose erythema.
Symptoms of different types of erythema infectiosum
The symptomatic manifestation of erythema in most cases is similar to other skin diseases. In order to diagnose a virus, consider a table of its different types and important characteristics:
| Type of disease | Duration | Manifestation on the skin | Symptoms |
| Rosenberg | More than 2 weeks. | The rash appears on the limbs and buttocks, patchy or in the form of nodules. | There is pain in the joints, muscles, head, sleep deteriorates, and an enlargement of the liver and spleen is observed. |
| Chamera | Lasts more than 15 days. | Accompanied by a symmetrical rash on the face in the shape of a butterfly. | The airways become inflamed, conjunctivitis and minor pain in the joints appear. IN exceptional cases the disease may have no symptoms. |
| Nodal | Including relapses, it can last from 21 to 25 days. | Red nodules with induration up to 5 centimeters appear on the skin, and pain occurs when pressure is applied. Fluid accumulates under the skin. The rash is located symmetrically on the front of the lower leg, forearms and thighs. | Hyperthermia and pain in the joints and head occur. |
| Multiform exudative | The average duration is 1 to 6 weeks, and frequent relapses may occur. | The rash manifests itself in different ways: ulcers, blisters, blisters. Located on the body and limbs. In some cases, ulcers and erosions in the anus and genital area may appear. Most often it occurs in the off-season, when the immune system is in a weakened state. | Frequent pain in the head, joints, muscles, hyperthermia and weakness appear. Are developing inflammatory processes V respiratory tract, the liver enlarges and the eyelids swell. |
| Sudden exanthema | Lasts no more than a week. | It appears as a pale pink rash all over the body. | Temperature rises sharply and headache. |
| Annular centrifugal erythema of Darier | Mostly it becomes chronic and relapses may occur. | On the body and limbs it appears as a red rash, as well as ring-shaped spots with a diameter of 2-3 centimeters. | Headache, hyperthermia and general malaise. |
| Toxic | Lasts several days. | The most severe reaction occurs in areas where there was contact with the allergen, but the rash can spread throughout the body. Itching and burning are observed. | Signs of intoxication of the body may appear. |
| Physiological | The duration of the disease is 1-6 weeks. In most cases it disappears within a few days. | The skin turns red and discomfort appears. | Passes without symptoms. |
The infectious form of the disease is transmitted by airborne droplets. If a baby has had erythema, the body produces antibodies, and he will not be able to become infected with it again.
Diagnosis of pathology
Only a dermatologist can diagnose this disease in children after examining the patient. Each subtype of the disease has its own symptoms, which most often appear on the skin. Thanks to this, the doctor can visually guess which virus is progressing in the child’s body.
To confirm the diagnosis, a general blood test is prescribed, since in many symptomatic manifestations erythema is similar to other diseases. The result obtained will help to significantly reduce the level of suspicion. IN individual cases A blood test may be prescribed to determine:
- Viral DNA;
- presence of antibodies in the blood.
If necessary, infected children may be given a referral to see an infectious disease specialist.
Treatment options
Therapy to eliminate erythema is carried out differently, depending on the type of disease, symptomatic manifestations and the factor that caused the spread of the virus. During the appointment, the doctor pays attention to the degree of damage to the skin and test results. When treating, follow the recommendations:
- Children should drink plenty of fluids - it helps remove toxins from the body.
- Avoid taking a bath during the treatment period. All hygiene procedures carried out under the shower.
- Children should not be there long time in cold, heat and under the scorching sun.
- Clothes are washed at a temperature of 60 degrees Celsius.
- Underwear should be changed daily.
In most cases, children are treated at home with mandatory bed rest. If the baby’s immune system is too weak or the virus has entered the blood, the doctor will recommend hospitalization.
Medication method
When treating erythema in children, the doctor may prescribe the following medications:
Physiotherapy
Physiotherapy is prescribed for erythema nodosum in children. The most commonly used procedure is electrophoresis. The affected areas of the skin are treated with solutions of potassium or sodium iodide. In rare cases, the doctor may prescribe the following:
- phonophoresis;
- laser therapy;
- magnetic therapy.
The final decision is made by a dermatologist, since for some types of erythema in children, physical therapy will not bring any benefit and may even be harmful.
Nutrition adjustments
The children's diet is adjusted according to the usual scheme for viral diseases. It excludes fatty, fried, smoked foods, and also significantly reduces the daily intake of salt. Doctors also recommend eliminating sweets from your diet, street food and citrus fruits, thereby minimizing the occurrence of allergic reactions.
ethnoscience
Erythema in children can be treated using folk tricks that will harmlessly help eliminate the virus from the body. The following will be effective:
- herbal decoctions of mint, lemon balm, chamomile;
- berry decoctions;
- tinctures of rosehip, red rowan, elderberry, hawthorn;
- lotions made from chamomile and oak bark;
- arnica-based ointment.
resort to folk medicine It is only worth it according to the indications of the attending physician.
Prognosis for recovery
Erythema infectiosum in children usually goes away in 2-3 weeks, if the course of the disease did not include complications. Correct treatment removes the virus from the body without consequences, and there are no scars left after the rash.
About 30% of children are infected sudden exanthema. Despite its prevalence, the virus is not dangerous and disappears within a week without complications. After recovery, antibodies are formed in the immune system, which subsequently prevent re-infection.
This disease has a large number of types that manifest themselves on the body of children in different ways. Examples of the spread of the rash over the skin are presented below.
Bottom line
Erythema in children occurs in the early stages of growing up and does not reappear after recovery. Children with weakened immune systems are at risk because the body is unable to fight the virus.
If the disease is not eliminated immediately, its harmless form can develop into a chronic one. If your child experiences the first signs of developing skin diseases, consult a doctor immediately.
This is a fairly common childhood infection, although the diagnosis of erythema infectiosum is rarely included in the cards - it is usually mistaken for any other childhood infections, allergies, dermatitis and other pathologies.
Adults can also get erythema infectiosum, but their course is different from that of children; the rash may appear on the face, which practically never happens in children. The disease belongs to the group respiratory infections, is transmitted by sneezing or coughing, by talking or shouting; in children it can be transmitted by using shared toys and if children put them in their mouths, through saliva. There may be cases of fifth disease spreading through shared utensils, spoons and plates, or through parental kisses. Typically, erythema infectiosum is transmitted when the first flu-like symptoms appear, and patients are contagious until the typical symptoms appear. skin rash. If the disease occurs in weakened children or adults who have various diseases blood, weakened immune system or any chronic diseases, they can remain infectious much more than usual and pose a great danger in epidemic terms.
Manifestations of the disease
Symptoms of erythema infectiosum may vary depending on the duration of the disease, the infectious dose of the virus and many other factors - age, concomitant pathologies, problems with the blood system, etc. The earliest symptoms of erythema infectiosum can be considered respiratory manifestations, reminiscent of the onset of influenza or a cold. The temperature rises, symptoms of a runny nose, sneezing, itchy nose, pain and sore throat, general malaise, chills, headaches, and loss of appetite occur.
Then, after a few days, the first manifestations of a rash on the body may appear; in some patients, when the rash appears, pain in the joints and muscles may also appear. Clinical manifestations of erythema infectiosum may have similar manifestations to many other diseases, with which doctors and patients often confuse them.
By development clinical symptoms fifth disease or erythema infectiosum may be similar to many childhood viral and microbial infections that develop a rash - scarlet fever, measles rubella, measles, roseola. In addition, erythema infectiosum may be similar to the manifestations of allergic reactions with the appearance of a skin rash - for example. In a similar way there is an allergy to the injection medical supplies(antibiotics, cough and fever syrups), contact dermatitis. In a similar way they can occur systemic diseases connective tissue– rheumatoid arthritis, systemic lupus erythematosus, scleroderma and similar conditions.
So, the main manifestations of erythema infectiosum include::
Cold-like symptoms that occur two to three days after exposure to viruses. Typically, the most initial symptoms may be mild malaise, discomfort in the nasopharynx and coughing. They can go virtually unnoticed by the patient, and then the disease proceeds subclinically, the rash can be short-lived and go unnoticed.
At typical course a clinic emerges:
- headache,
- abdominal pain,
- temperature rise to 38 degrees or slightly higher,
- joint pain,
- general weakness, weakness, decreased performance.
In the case of a typical manifestation of a rash, it appears according to a certain plan, goes through two or three natural stages in its development - first of all, a bright red rash appears in the cheek area, while the face and cheeks look as if a child was whipped on the cheeks. Sometimes the rash can spread to the chin or forehead. This rash lasts no more than two to five days and goes away without a trace.
In the second stage, the rash can appear in the neck, torso, forearms, shoulders, upper legs, knees and buttocks. The rash appears as red, round spots and then begins to grow in a “lace” pattern. The rash may be itchy, especially in older children and adults. On average, this stage of the rash lasts about a week or a little less.
Then the rash goes away completely, but under the influence of direct sunlight, stress or high temperature, the rash may reappear in the same places. This rash will last from one to three weeks, but if the rash reoccurs, it does not indicate a worsening of the condition.
One of the symptoms of erythema infectiosum is joint pain, usually affecting joints in the wrists and elbows, ankles and knees, more small joints fingers and toes. This happens especially often in girls and women; the pain can last from one to three weeks, although occasionally there may be painful sensations of a more lasting nature. In this case, there is no swelling or redness of the joint, except unpleasant and not severe painful sensations there may be nothing more.
What complications can there be?
With the development of erythema infectiosum or otherwise fifth disease, in some cases quite serious complications, although this does not always happen. First of all, with erythema infectiosum the formation of new red blood cells (erythrocytes) may stop for some time, but usually in healthy children or adults this phenomenon goes unnoticed and does not cause significant problems with hematopoiesis.
If a child or adult has problems with the blood system and red blood cells, such as thalassemia or sickle cell disease, then serious blood complications can occur. With a temporary cessation of red blood cell synthesis, the phenomenon of aplastic crisis, a decrease in the number of blood cells in the blood, may occur, which can last from seven to ten days. This disease will become even more dangerous for people with manifestations of aplastic anemia - their health and general well-being can be significantly affected. Then symptoms of fever, lethargy, increased heartbeat, increased breathing and other troubles appear.
If a child exhibits signs of immunodeficiency, the disease with this type of virus can develop into chronic carriage, which will ultimately lead to the formation of a fairly severe lesion bone marrow and hematopoiesis with the formation of persistent and treatment-resistant anemia.
Methods for diagnosing the disease
Clinical and laboratory diagnostics this type of disease is quite difficult. This is due to the fact that doctors in local practice are little familiar with such an infection, and it is rarely diagnosed. Usually the diagnosis can be assumed clinically by the presence of a certain typical “lace” rash, after detailed questioning about the state of health and possible reasons and methods of infection, and also confirm the data by the presence on the body of a typical rash in the sherry area, body, legs and arms.
In addition to the clinical picture, a number of laboratory tests are necessary to confirm the diagnosis - serological examinations can be carried out to identify the titer of antibodies to the virus, which remains high for three months from the onset of the disease. This is especially true in the presence of arthritis - lesions large joints, and without the typical clinical picture of a cold and the presence of a rash. In order to exclude microbial infection or complications, general blood tests are performed. The purpose of this analysis is to obtain important information– how much the hematopoietic system is affected by the virus and what consequences may occur as a result of the virus. First of all, the number of red blood cells and the degree of regeneration of red blood cells based on the level of reticulocytes are studied. It is also important to look at the state of leukocytes and platelets, since they are also involved in hematopoiesis and can decrease in parallel with red blood.
Also, a blood test can assess the effectiveness of treatment and the beginning of the recovery period. It is especially important to closely monitor the blood test in the presence of anemia and a decrease in the number of reticulocytes against its background, as well as when signs appear fatigue, pale skin and weakness.
Treatment options for erythema infectiosum
In case of erythema infectiosum in ordinary healthy children or adults, home treatment is indicated according to the principles of treatment of all viral infections. It is necessary to maintain bed rest during fever, take plenty of fluids, take antiviral and symptomatic remedies. Remember that the rash can be two or three waves and its reoccurrence should not be mistaken for an exacerbation of the infection or a worsening of the condition. It is often worth limiting hot baths, tanning salons, or the beach to prevent the rash from appearing again. During illness, it is worth isolating yourself from stress and anxiety, they also provoke repeated rashes.
Antibiotics are not indicated for the treatment of erythema infectiosum; this is a viral disease and there is simply nothing to fight with an antibiotic. Their appointment will be justified when microbial complications, sore throat, pneumonia or otitis occur.
Erythema infectiosum can be dangerous during pregnancy, with a weakened immune system, or in people with blood diseases. In this case, hospitalization in a hospital and constant dynamic monitoring of the condition with blood tests and monitoring of hematopoiesis are indicated. Pregnant women are additionally prescribed ultrasonography condition of the fetus and assessment of its health status, as well as a detailed blood test and blood clotting tests.
Quarantine measures for erythema infectiosum have not been developed, the patient becomes non-infectious from the moment the rash appears; if his condition is satisfactory, he can attend school or kindergarten. IN given time Work is underway to develop a vaccine against the B19 virus and it is possible that active vaccine prevention of this disease will soon be carried out.
The situation is much more complicated with children suffering from aplastic or other types of anemia; due to impaired hematopoiesis, they may develop severe oxygen deficiency syndrome due to a decrease in the number of cells and hemoglobin (aplastic crisis). In such cases, even transfusions of red blood cells of the same blood type and Rhesus may be indicated to ensure sufficient delivery of oxygen to the tissues. This is carried out only according to indications and only in a hospital.
Methods home treatment children
With the development of erythema infectiosum it is indicated symptomatic treatment at home, it includes:
- antipyretics based on paracetamol for high temperature for joint pain,
- copious fluid intake,
- children need to cut their nails short so that when itching they do not scratch the skin,
- at severe itching cool baths with starch, oatmeal or taking antihistamines,
- Calamine lotion can help relieve itching and dry skin.
Erythema infectiosum is sometimes called fifth disease.
Erythema infectiosum in children can affect any childhood. Adults also get sick, without age restrictions. In adult patients, joint damage is common.
It has been noted that this infection is more severe in women and most often occurs in the spring and winter.
Erythema infectiosum in children is transmitted by airborne droplets. The patient remains infectious throughout the entire clinical picture of the lesion skin. The percentage of people infected after contact with a sick child is 50 percent.
Clinical picture and symptoms of erythema infectiosum in children
The incubation period lasts from 4 to 14 days. The main manifestations of the disease, in addition to skin manifestations, are: fever, general malaise, lethargy, and sometimes a runny nose. When the rash appears, clinical picture The course of the disease is accompanied by nausea, cough, diarrhea, and fever. Arthralgia rarely occurs. Skin itching may develop.
The rash in nature resembles “slapped cheeks.” On the child’s torso and limbs, the rash merges into a mesh or lace pattern. It is extremely rare that the rash resembles a measles rash, which makes it difficult to differentiate the diagnosis.
It is very important to differentiate erythema infectiosum, as was said with measles, rubella, scarlet fever, and enteroviral infections.
A rash in the form of slapped cheeks is characteristic diagnostic sign, after 1-4 days it disappears. After this, a lace-like rash forms on the child’s skin, which is localized on the neck and extensor surfaces of the limbs.
It is characteristic that erythema infectiosum in children can clearly manifest its clinical signs from 5 to 9 days, but sometimes after overheating or hypothermia, under the influence of sunlight, with increased emotional or physical stress, it can appear again, even many months later. past illness.
Treatment of erythema infectiosum
Treatment of erythema infectiosum in children is symptomatic and is aimed at reducing the risk of developing possible complications. It is necessary to stop the child’s feverish conditions and, using antiseptic solutions, to prevent secondary infection of the skin through the elements of the rash.
Erythema infectiosum, a viral disease, is characterized by the appearance of a rash throughout the skin, as well as cold symptoms. Children and teenagers most often suffer from this scourge, but sometimes it complicates the lives of adults as well.
In most cases, the disease is transmitted by airborne droplets, and it can also be triggered by problems with the blood. This pathology is especially dangerous for women who are carrying a child, as it can lead to miscarriage and various lesions in the fetus.
Classification of the disease
Erythema is an acute viral disease and is almost always accompanied by an increase in body temperature, the appearance of red spots on the face (wet and dry), and a rash throughout the body.
Doctors call this pathology the fifth disease - erythema infectiosum is in the same group with herpes, toxoplasmosis, rubella and cytomegalovirus infection. Its causative agent is a virus of the parvovirus group. This disease appears only once. After recovery, the body develops lifelong immunity.
Currently, doctors classify it as infection into several different types:
- Sudden exanthema is considered the simplest form of the disease and is easily treatable. The rash and fever usually last no more than 3 days and often go away even without medical intervention.
- Infectious Erythema of Chamera - in this form, the body temperature usually remains within normal limits, a spotty rash is localized on the face and appears from the first day of illness.
- Erythema of Rosenberg. Its first sign is a pronounced fever with general intoxication. Rash and redness usually appear on the 5th day of the disease, and they usually form on the torso, while the face remains clear.
- Exudative erythema multiforme - not only a rash and redness appears on the body, but also blisters of various diameters with clear liquid inside. If they form on mucous membranes, there is a possibility ulcerative lesion mouth, pharynx, genitals.
- - characterized by the appearance of dense red nodules, which, when pressed, will cause pain. These nodules rise slightly above the skin and over time acquire a yellowish tint. Viral erythema nodosum goes away no sooner than after 3 weeks.
- Undifferentiated form - has no specific features and occurs easily. The rash appears on different areas body and face.
Since all these conditions are characterized by special symptoms and the nature of the rash, they cannot transform into each other.
Causes
Erythema infectiosum in children and adults most often develops for the same reasons. On initial stage it causes only minor rashes and mild discomfort, after which the condition stabilizes.
Doctors say that a person can suffer from this disease only once, after which immunity is developed. The primary source of erythema infectiosum is most often the following factors:
- weakening of the body's protective properties;
- lack of vitamins and various microelements;
- presence of chronic diseases;
- presence of blood diseases.
Symptoms
Parvovirus affects the body in such a way that at the initial stage a person’s condition is very similar to a common cold. The patient begins to constantly sneeze, he develops general weakness, headache, and loss of appetite.
After 3-4 days, a rash begins to form on the skin, and the body temperature will rise to 37-38 degrees. But in rare cases the indicator rises to 40 degrees. In some patients, the headache is so severe that it resembles a migraine.
There is also often the occurrence of discomfort and pain in the abdominal cavity. As a rule, the rash begins to appear on the 4th day, it manifests itself in stages:
- the appearance of red spots on the cheeks (with uneven outlines);
- the appearance of a rash on the chin and forehead;
- distribution of red spots throughout the body. They can completely cover the body in just a few hours;
- the appearance of severe itching and burning (such sensations will last about a week).
With erythema infectiosum in adults and children, redness and itching will increase several times after exposure to the sun. To speed up treatment, doctors strongly recommend avoiding exposure to sunlight.
Diagnostics
In order to select the appropriate treatment method and prescribe the right medications, the specialist needs to make sure that the person is faced with erythema; it is especially important to correctly diagnose the child.
The difficulty is that this disease has symptoms similar to others skin diseases, so it is often diagnosed untimely. To correctly identify this disease, it is necessary not only to examine the patient and collect anamnesis, but also to prescribe some laboratory and instrumental studies.
If a patient is suspected of having this infection, the standard diagnostic plan includes:
- a comprehensive examination of the patient, identifying the location of the rash and assessing the type of neoplasm;
- serological examination, which shows a number of antibodies to the virus;
- complete blood count (to determine the level of red blood cells, leukocytes and platelets);
- linked immunosorbent assay.
If necessary, the patient may also be prescribed a consultation with more specialized specialists - a dermatologist and an infectious disease specialist.
Treatment
Since erythema has a viral etiology, it is impossible to cure it in a specific way; the approach must be comprehensive.
Most doctors believe that treatment should be aimed at eliminating symptoms. If a person experiences an increase in temperature, he is given antipyretics; if pain occurs, he is given painkillers.
The use of antibiotics is prescribed extremely rarely, only if the disease is accompanied by sore throat, pneumonia or otitis media. If the disease is difficult to treat, doctors can also supplement the course with glucocorticosteroids.
Treatment in most cases is carried out at home, and full recovery occurs within 3 weeks. The spots and rash begin to disappear approximately 5 days after starting to take the prescribed medications, first they clear lower limbs, and then top part torso.
To speed up the recovery process and not provoke complications, patients are advised to spend as little time outdoors as possible and not to apply decorative cosmetics to the skin.
Patients should also adhere to bed rest and drink plenty of fluids. During the treatment period, it is strictly contraindicated to take hot baths and be in the sun.
Experts say that if the patient is prescribed suitable medications, there is a possibility of reappearance diseases.
You cannot prescribe medications yourself to treat erythema infectiosum; if the medications are chosen incorrectly, this can only aggravate the situation and provoke complications.
Treatment of erythema in children
Erythema infectiosum in children is treated slightly differently because children's body is more vulnerable and susceptible to modern medications. If the child has this diagnosis confirmed, then everything therapeutic measures will be aimed at reducing the likelihood of complications.
The baby will also need to adhere to bed rest, take antipyretic medications and drink as much fluid as possible. Treatment of areas with rashes has also proven to work very well. antiseptic solutions and ointments for external use.
Erythema in children is difficult to treat. If treatment is started in a timely manner, the baby’s condition will improve significantly in 7-9 days. In order to reduce the risk of relapse of the disease, in the first months after recovery the child will need to be protected from the following factors:
- stress, nervous experiences, emotional tension;
- hypothermia;
- prolonged exposure to sunlight.
Erythema infectiosum - extremely unpleasant illness, which can appear at virtually any age. Unfortunately, there is no specific prevention for this disease.
In order to minimize the risk of illness, it is necessary to constantly monitor your health, promptly treat underlying diseases and strengthen your immune system. If you develop a fever or skin rash, you should make an appointment with your doctor as soon as possible.
Erythema infectiosum in children and adults most often develops for the same reasons. At the initial stage, it causes only small rashes and mild discomfort, after which the condition stabilizes.
The reasons for the development of erythema infectiosum have not been sufficiently studied, although it is known for sure that the disease is caused by paravirus B19 (B19V) and as a consequence of this virus, viral exanthems may appear.
The infection is transmitted predominantly by airborne droplets, however, its contagiousness (susceptibility to infection) is low. There are other ways of transmitting the infection; the virus can enter the body through a blood transfusion from an infected person, and infection of the fetus occurs through the placenta.
Parovirus B19, which causes the development of erythema infectiosum, is a single-stranded, non-enveloped DNA virus with a diameter of 18-24 nm.
Erythema infectiosum usually manifests itself in sporadic outbreaks in child care institutions or families. After suffering from the disease, a person develops stable lifelong immunity.
It must be said that when carrying out serological studies during outbreaks of the viral form of erythema, show that approximately 80% of those examined experience the disease in a subclinical (asymptomatic) form.
The disease is caused by human parvovirus B19. Probably spread by airborne droplets high level secondary infection through household contacts; The infection may occur without symptoms or signs.
Parvovirus B19 causes transient suppression of erythropoiesis that is mild and asymptomatic, except in children with underlying hemoglobinopathies (eg, sickle cell disease) or other red blood cell diseases (eg, hereditary spherocytosis), from which aplastic transitional crisis may develop.
In addition, immunocompromised children may develop prolonged viremia (lasting weeks or months), resulting in severe anemia (purified red cell aplasia).
Classification of the disease
Erythema is an acute viral disease and is almost always accompanied by an increase in body temperature, the appearance of red spots on the face (wet and dry), and a rash throughout the body.
Doctors call this pathology the fifth disease - erythema infectiosum is in the same group as herpes, toxoplasmosis, rubella and cytomegalovirus infection.
Its causative agent is a virus of the parvovirus group. This disease appears only once.
After recovery, the body develops lifelong immunity.
Symptoms and signs of erythema infectiosum in children
Typical initial presentations are nonspecific influenza-like symptoms (eg, slight increase temperature, slight malaise). A few days later, a fixed confluent erythema appears on the cheeks (slap-like appearance) and a symmetrical rash appears that is most noticeable on the arms, legs, and trunk and usually spares the palms and soles.
The rash is maculopapular, tending to merge, it forms a mesh or lacy pattern, slightly raised, covered with spots with clearing in the center, as a rule, most pronounced on open areas of the skin.
The rash and all manifestations of the disease usually last 5-10 days. However, the rash may recur within a few weeks, making it worse sunlight, physical activity, fever, fever or emotional stress.
Mild joint pain and swelling (non-erosive arthritis), which may persist or recur for weeks or months, sometimes occurs in adults.
Symptoms of toxic erythema
Parvovirus affects the body in such a way that at the initial stage a person’s condition is very similar to a common cold. The patient begins to constantly sneeze, he develops general weakness, headache, and loss of appetite.
After 3-4 days, a rash begins to form on the skin, and the body temperature will rise to 37-38 degrees. But in rare cases the indicator rises to 40 degrees. In some patients, the headache is so severe that it resembles a migraine.
Symptoms of fifth disease may vary depending on the infectious dose of the virus, the duration of the illness and many other factors - concomitant pathologies, age, problems with the hematopoietic system, etc.
As noted above, the most early symptoms Erythema infectiosum is a respiratory manifestation that resembles the onset of a cold or flu. Body temperature rises, sneezing, runny nose, itchy nose, sore throat and sore throat appear, general malaise, loss of appetite and headaches are observed.
Then after a few days the first rash may appear. In addition to the rash, some patients may experience muscle and joint pain.
Erythema infectiosum clinical signs has some similarities with other ailments with which they are often confused by patients and doctors. Thus, fifth disease is similar to many childhood microbial and viral infections that occur with the development of a rash - measles rubella, scarlet fever, roseola, measles.
In addition, rashes with erythema infectiosum are similar to the manifestation of allergic reactions with the appearance of a rash on the skin. Allergies to the administration of medications (syrups for fever and cough, antibiotics) and contact dermatitis also occur.
Connective tissue diseases occur similarly - systemic lupus erythematosus, rheumatoid arthritis, scleroderma and similar conditions.
So, the main manifestations of erythema infectiosum are: 1. Cold-like symptoms that appear four days after the virus is exposed to the body.
2. Usually the most initial symptoms erythema infectiosum - discomfort in the nasopharynx, slight malaise, coughing.
The patient may not notice these symptoms, and then the disease is subclinical - the rash is short-lived and goes unnoticed.
The clinical picture of the disease varies somewhat among patients depending on their age, the presence of concomitant pathologies, in particular blood diseases, and some other factors.
The first symptoms of erythema infectiosum are respiratory signs reminiscent of the onset of a cold or flu: a person’s body temperature rises, a runny nose, itchy nose, sore throat, chills and headache appear, decreased appetite, and general weakness.
A few days later, a rash appears on the body; in adults, it is often accompanied by muscle and joint pain.
Considering the nonspecificity of the symptoms of erythema infectiosum, which are similar to many other diseases, it should be diagnosed on early stage succeeds extremely rarely.
The disease is often confused with microbial and viral infections such as roseola, scarlet fever, rubella, and measles. Sometimes erythema is mistaken for contact dermatitis or allergic reaction body, for example, to drugs.
It is worth noting that similar signs are also characteristic of some connective tissue diseases (scleroderma, rheumatoid arthritis, systemic lupus erythematosus).
Quite often, erythema infectiosum occurs in a subclinical (asymptomatic) form. In this case, the rash is usually short-lived or does not appear at all, and cold symptoms disappear in a couple of days, so patients do not even suspect that they were suffering from fifth disease.
The onset of the disease expresses in children an increase in sensitivity to certain diseases. Diagnosis of the disease indicates the onset of a primary infection.
Symptoms of skin lesions erythema nodosum Children can be observed individually. Many of them depend on the cause of the onset of the disease.
The most striking signs are:
- formation of red nodules;
- spots that predominate on the front of the lower legs;
- the incubation period before rash can be several weeks;
- accompanying muscle and joint pain;
- low-grade or high fever;
- merging of nodular formations into a large ring, up to 10-13 cm in diameter;
Diagnostic methods
In order to select the appropriate treatment method and prescribe the right medications, the specialist needs to make sure that the person is faced with erythema; it is especially important to correctly diagnose the child.
The difficulty is that this disease resembles other skin diseases in its symptoms, so it is often diagnosed untimely. To correctly identify this disease, it is necessary not only to examine the patient and collect anamnesis, but also to prescribe some laboratory and instrumental studies.
If a patient is suspected of having this infection, the standard diagnostic plan includes:
- a comprehensive examination of the patient, identifying the location of the rash and assessing the type of neoplasm;
- serological examination, which shows a number of antibodies to the virus;
- complete blood count (to determine the level of red blood cells, leukocytes and platelets);
- linked immunosorbent assay.
If necessary, the patient may also be prescribed a consultation with more specialized specialists - a dermatologist and an infectious disease specialist.
Clinical and laboratory diagnosis of the infectious form of erythema is a very difficult task, since the symptoms of the disease are similar to those of many other diseases.
Upon external examination, erythema infectiosum should be suspected by the typical, “lacey” appearance of the rash.
To make a correct diagnosis, it is necessary to carry out a number of tests, in particular:
- Serological examination to detect antibodies to the virus.
- Conducting a general analysis to determine the level of red blood cells, platelets and leukocytes in the blood.
General analysis blood tests should also be carried out during treatment so that the effectiveness of the therapy can be assessed.
A differentiated diagnosis is required with diseases such as:
When fields appear in the joints, it is necessary to distinguish the infectious form of erythema from:
Rubella can be excluded by serological testing; Patient contact data are also useful. Serological testing is not required in healthy children, but in children with transient aplastic crisis or adults with arthropathy, the presence of specific IgM antibodies to parvovirus B19 at the end or at the beginning acute phase recovery clearly confirms the diagnosis.
Parvovirus B19 viremia can also be detected using quantitative PCR methods, which are typically used for patients with transient aplastic crisis, immunocompromised patients with red cell aplasia, and infants with hydrops fetalis or congenital infections.
As mentioned a little above, diagnosing fifth disease presents some difficulties. A reason to suspect erythema infectiosum is the presence of “lace” on the body, typical for a rash of this disease.
Patients are also prescribed laboratory research. A complete blood count is carried out primarily to determine the level of red blood cells, but also to determine the number of white blood cells and platelets, since they are also involved in the process of hematopoiesis.
To determine antibodies to the virus, a serological examination is prescribed.
Treatment of erythema in children
Since erythema has a viral etiology, it is impossible to cure it in a specific way; the approach must be comprehensive.
Erythema infectiosum in children is treated a little differently, since the children's body is more vulnerable and susceptible to modern medications. If this diagnosis is confirmed in a child, then all treatment measures will be aimed at reducing the likelihood of complications.
The baby will also need to adhere to bed rest, take antipyretic medications and drink as much fluid as possible. Treatment of areas with rashes with antiseptic solutions and ointments for external use has also proven to be very effective.
Erythema in children is difficult to treat. If treatment is started in a timely manner, the baby’s condition will improve significantly in 7-9 days. In order to reduce the risk of relapse of the disease, in the first months after recovery the child will need to be protected from the following factors:
- stress, nervous experiences, emotional tension;
- hypothermia;
- prolonged exposure to sunlight.
Erythema infectiosum is an extremely unpleasant disease that can appear at virtually any age. Unfortunately, there is no specific prevention for this disease.
In order to minimize the risk of illness, it is necessary to constantly monitor your health, promptly treat underlying diseases and strengthen your immune system. If you develop a fever or skin rash, you should make an appointment with your doctor as soon as possible.
For erythema infectiosum in children and adults, hospitalization is usually not required. The principle of treatment for this disease is similar to the scheme adopted for the treatment of any other viral infections.
- During a febrile state with erythema infectiosum, bed rest is indicated.
- It is necessary to take a large amount of liquid.
- An appointment is scheduled antiviral drugs and means to alleviate the symptoms of the disease.
- The appearance of the second and subsequent waves of rash is not an indicator of the severity of the disease; with erythema infectiosum it is simply characteristic feature diseases.
- During the treatment of erythema, you should avoid exposure to the open sun or solarium, and you should limit taking hot baths.
- Since erythema infectiosum is a viral disease, antibiotics are not prescribed for its treatment. However antibacterial therapy may be required if microbial complications, pneumonia, tonsillitis or otitis media are added to the erythema.
Since erythema infectiosum poses a certain danger to the fetus, pregnant women who become ill are placed in a hospital for the duration of treatment. Therapy is carried out under constant monitoring laboratory parameters blood and regular ultrasound examinations of the fetus.
Hospitalization for the treatment of erythema infectiosum is also indicated for patients with immunodeficiency and diseases of the hematopoietic system.
Herbal medicine methods can be used as an addition to the doctor-selected treatment for erythema infectiosum.
Only symptomatic treatment is necessary. Intravenous immunoglobulin has been used to reduce viremia and enhance erythropoiesis in immunocompromised children with red cell aplasia.
With the development of erythema infectiosum in children, symptomatic treatment at home is indicated, it includes:
- Antipyretic drugs based on paracetamol or ibuprofen for joint pain and high fever;
- Drink plenty of fluids (warm tea, compote, water, fruit drinks, juices);
- Trim your children's nails short to prevent them from scratching their skin when itching occurs;
- For severe itching, taking antihistamines and cool baths with oatmeal and starch are recommended;
- Calamine lotion will help relieve itching and relieve dry skin.
The mode of transmission of fifth disease in children is airborne. Erythema infectiosum in children is often transmitted by sharing toys, especially when they put them in their mouths. After contact with a sick child, the percentage of people infected is 50%. There are cases of spread of erythema infectiosum through shared plates, spoons and other utensils, as well as through hugs and kisses of parents.
Treatment of erythema infectiosum in children and adults is usually carried out at home. The treatment regimen is similar to that for viral infections, only antibiotics are not prescribed, since this disease is not of viral etiology.
For periods accompanied by fever and fever, bed rest, drinking plenty of fluids, antiviral and symptomatic medications. Before full recovery All patients are advised to limit exposure to the sun and take hot baths, and avoid visiting the solarium.
Antibacterial drugs for the treatment of erythema infectiosum are prescribed only in the case of microbial complications, pneumonia, sore throat or otitis media.
Since fifth disease is dangerous for people with weakened immunity and blood diseases, as well as for pregnant women, treatment of such patients is carried out in a hospital under the supervision of doctors and monitoring of laboratory parameters.
Quarantine measures are not taken for erythema infectiosum, since from the moment the rash appears a person becomes non-infectious, and it is by the characteristic rashes that the disease is most often diagnosed.
Currently, scientists are actively working to create a vaccine against parvovirus B19, and therefore it is likely that children will be vaccinated against this disease in the near future.
Prevention and prognosis
The prognosis for erythema infectiosum is favorable. The patient is subject to isolation from the moment flu-like symptoms appear, but after the appearance of the rash does not pose a danger to others. Therefore, when feeling normal With erythema infectiosum, you can lead a normal lifestyle.
Unfortunately, you can also become infected with erythema infectiosum from a carrier of the virus or from a patient whose disease is asymptomatic. It is impossible to recognize such people, therefore effective measures there is no prevention. However, you can reduce the risk of getting an infection. For this it is recommended:
- If possible, avoid contact with people who have symptoms viral disease(runny nose, cough, etc.).
- Wash your hands as often as possible, especially after returning from the street.
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