Fifth disease - Femte Sygdom
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16 måneder gammel med Femte Sygdom (Fifth disease) ― Begge kinder bliver røde, som om de blev slået, og makulopapulære udslæt vises på kroppen.
Erytem på begge kinder.
relevance score : -100.0%
ReferencesFifth disease, også kendt som erythema infectiosum, er en virusinfektion forårsaget af humant parvovirus B19. Den er mest udbredt hos børn og rammer typisk dem i alderen 4 til 14 år. Symptomerne begynder ofte med let feber, hovedpine, ondt i halsen og influenzalignende fornemmelser. Børn kan udvikle et tydeligt rødt udslæt i ansigtet, der ligner slapped cheeks, samt et mønstret udslæt på krop, arme og ben. Hos voksne er ledsmerter en almindelig klage, som kan opstå uger efter den første infektion. Det er bemærkelsesværdigt, at omkring 20–30 % af voksne, der er inficeret med parvovirus B19, muligvis ikke udviser nogen symptomer.
Fifth disease (erythema infectiosum) is a viral infection caused by human parvovirus B19. It is more common in children than adults and usually affects children ages 4 to 14. The disease often starts with mild fever, headache, sore throat, and other flu-like symptoms. Children can also develop a bright red rash on the face that looks like “slapped cheeks”, along with a lacy or bumpy rash on the body, arms, and legs. In adults, joint aches are a common symptom. Rash and joint symptoms may develop several weeks after infection. About 20 to 30% of adults who are infected with parvovirus B19 will not have symptoms.
Fifth disease (erythema infectiosum) is a viral infection caused by human parvovirus B19. It is more common in children than adults and usually affects children ages 4 to 14. The disease often starts with mild fever, headache, sore throat, and other flu-like symptoms. Children can also develop a bright red rash on the face that looks like “slapped cheeks”, along with a lacy or bumpy rash on the body, arms, and legs. In adults, joint aches are a common symptom. Rash and joint symptoms may develop several weeks after infection. About 20 to 30% of adults who are infected with parvovirus B19 will not have symptoms.
Risikoen for at overføre parvovirus B19 fra mor til barn er omkring 33 %, og omkring 3 % af de inficerede kvinder får komplikationer hos deres baby. Hvis moderen bliver smittet før 20. uge af graviditeten, øges risikoen for komplikationer såsom blodproblemer og væskeophobning i barnets krop. For at kunne håndtere sygdommen bør vi undersøge, om patienten tidligere har været udsat for parvovirus ved at teste for specifikke antistoffer (IgM). Hvis testen ikke viser tidligere eksponering, men indikerer en nylig infektion, skal patienten nøje overvåges under graviditeten, herunder med regelmæssige ultralydsscanninger for at opdage eventuelle problemer hos barnet.
The rate of vertical transmission during maternal parvovirus B19 infection is estimated at 33%, with fetal complications occurring in 3% of infected women. Fetal complications comprising hemolysis, anemia, and nonimmune hydrops fetalis and fetal loss are more frequent when maternal infection occurs before 20 weeks of gestation. The first step in the management of this patient would be to obtain immunoglobulin (Ig) M and IgG titres against parvovirus to evaluate if the patient has had previous immunity against the disease. If results are negative for IgG but positive for IgM (ie, primary infection), this patient would need close obstetrical monitoring for the following weeks, including serial ultrasounds to rule out fetal anemia and hydrops fetalis.
The rate of vertical transmission during maternal parvovirus B19 infection is estimated at 33%, with fetal complications occurring in 3% of infected women. Fetal complications comprising hemolysis, anemia, and nonimmune hydrops fetalis and fetal loss are more frequent when maternal infection occurs before 20 weeks of gestation. The first step in the management of this patient would be to obtain immunoglobulin (Ig) M and IgG titres against parvovirus to evaluate if the patient has had previous immunity against the disease. If results are negative for IgG but positive for IgM (ie, primary infection), this patient would need close obstetrical monitoring for the following weeks, including serial ultrasounds to rule out fetal anemia and hydrops fetalis.
Den starter med lavgradig feber, hovedpine, udslæt og forkølelseslignende symptomer såsom løbende eller tilstoppet næse. Disse symptomer aftager, og et par dage senere fremkommer udslættet. Det lyse røde udslæt ses oftest i ansigtet, især på kinderne (deraf navnet “slået kindsyge”). Ud over de røde kinder udvikler børn ofte et rødt, blødt udslæt på resten af kroppen, hvor overarme, torso og ben er de mest almindelige steder.
Sygdommen er normalt mild, men hos gravide kvinder er infektion i første trimester blevet forbundet med hydrops fetalis, som kan forårsage spontan abort.
○ Behandling
Der kræves ingen specifik behandling, da den normalt forbedres over tid.