Fifth disease - 第五病
16个月大的孩子患第五病 (Fifth disease)——两颊呈红斑，像被打了一巴掌，身体出现斑丘疹。
双颊出现红斑。
relevance score : -100.0%
ReferencesFifth disease，也称为传染性红斑，是由人类细小病毒 B19 引起的病毒感染。它在儿童中更为常见，通常影响 4 至 14 岁的儿童。症状常以轻度发热、头痛、咽喉痛和类似流感的感觉开始。孩子的面部可能出现明显的红色皮疹，呈 “slapped cheeks” 样，身体、手臂和腿部也会出现斑块状皮疹。成人常出现关节疼痛，可能在首次感染后数周出现。值得注意的是，约 20% 至 30% 的感染细小病毒 B19 的成年人可能没有任何症状。
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.
Parvovirus B19 由母亲传染给婴儿的风险约为 33%，约 3% 的受感染孕妇的婴儿会出现并发症。母亲若在妊娠 20 周前感染，出现血液异常和胎儿体内积液等并发症的风险会增加。诊断时应检测 IgM 抗体，以判断患者是否曾接触 Parvovirus B19(细小病毒B19)。若检测显示既无既往感染史但 IgM 阳性，提示近期感染，需在孕期进行密切监测，包括定期超声检查胎儿健康状况。
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.
第五病 (fifth disease) 以低热、头痛、皮疹和类似感冒的症状（如流鼻涕或鼻塞）开始。上述症状消退后，几天内出现皮疹。鲜红色皮疹最常见于面部，尤其是脸颊（因此得名“拍打脸颊病”）。除了脸颊发红外，儿童常在上臂、躯干和腿部出现红色、花边状的皮疹。
该疾病通常较轻，但孕妇在妊娠前三个月感染，可能导致胎儿水肿，增加自然流产的风险。
○ 治疗
无需特殊治疗，病情一般会随时间自行好转。