Denouement and Discussion
(Fifth Disease)CONTRIBUTED BY WILLIAM B. WADLINGTON, MD 2614 OLD LEBANON RD, DONELSON, TENN 37214
This condition is probably viral in origin but as yet no viral agent has been isolated. It is thought to spread by droplet infection.
Four to 14 days.
Children between the ages of 3 and 12 are most frequently affected, but the disease has been reported in infants and adults.
SYMPTOMATOLOGY AND PHYSICAL FINDINGS
Usually there are no prodomal symptoms, although low grade fever, headache, and malaise sometimes occur for one or two days. The rash is the most striking manifestation of erythma infectiosum. The first stage consists of an extremely bright erythema of the cheeks with circumoral pallor or at least absence of rash around the mouth.The second stage occurs one to four days after the appearance of the malar erythema with the