Parvovirus B19 infection is classically associated with which pediatric syndrome?

• A. Measles
• B. Rubella
• C. Fifth disease
• D. Scarlet fever

Answer: (C)

Parvovirus B19 in children is classically linked to erythema infectiosum, the condition historically called fifth disease. The hallmark presentation is a bright red, “slapped-cheek” facial rash that may be followed by a reticular, lace-like rash on the trunk and limbs. This pattern—the cheek rash with a subsequent body rash—defines the pediatric syndrome associated with Parvovirus B19. Other listed illnesses have different features: measles often starts with fever and Koplik spots followed by a blotchy rash; rubella presents with tender lymphadenopathy and a fine rash; scarlet fever features a sandpaper-like rash and sometimes a strawberry tongue. In addition, Parvovirus B19 can cause arthralgias in older children and adults or, in those with hemolytic anemia, aplastic crises, but the classic pediatric presentation remains erythema infectiosum, or fifth disease.