Fifth disease - 第五病
16個月大的第五病 (Fifth disease) ― 兩頰呈紅色，彷彿被打了一巴掌，身體出現斑丘疹。
兩頰出現紅斑。
relevance score : -100.0%
ReferencesFifth disease，也稱為傳染性紅斑，是由人類細小病毒 B19 引起的病毒感染。它在兒童中較為常見，通常影響 4 至 14 歲的兒童。症狀多以輕微發燒、頭痛、喉嚨痛及類流感症狀開始。孩子的臉上可能出現類似 slapped cheeks 的明顯紅色皮疹，身體、手臂和腿部也會出現斑點狀皮疹。成人常見關節疼痛，可能在首次感染後數週出現。值得注意的是，約 20% 至 30% 的 B19 感染成年人可能不會出現任何症狀。
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 由母親傳給嬰兒的風險約為 33%，約有 3% 的受感染孕婦之嬰兒會出現併發症。若母親在懷孕 20 週前感染，發生血液異常及胎兒體內積水等併發症的機率會增加。為了及早治療，我們應檢測 IgM 抗體，以判斷患者是否曾接觸過細小病毒。若檢測結果顯示過去未曾接觸，但 IgM 陽性提示近期感染，則需在孕期進行密切監測，包括定期超音波檢查胎兒健康狀況。
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) 以低燒、頭痛、皮疹以及類似感冒的症狀（如流鼻水或鼻塞）開始。這些症狀消退後，幾天內會出現皮疹。鮮紅色皮疹最常見於臉部，尤其是臉頰（因此得名「拍打臉頰病」）。除了臉頰發紅外，兒童常在身體其他部位出現紅色、花邊狀的皮疹，上臂、軀幹和腿部是最常見的部位。
此疾病通常較輕，但若孕婦在懷孕前三個月感染，可能與胎兒水腫有關，導致自然流產。
○ 治療
不需要特殊治療，因為它通常會隨時間自行改善。