Fifth disease medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Treatment of fifth disease is mainly symptomatic. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen to relieve symptoms.

Medical Therapy

Treatment of symptoms such as fever, pain, or itching is usually all that is needed for fifth disease. Adults with joint pain and swelling may need to rest, restrict their activities, and take medicines such as aspirin or ibuprofen to relieve symptoms. The few people who have severe anemia caused by parvovirus B19 infection may need to be hospitalized and receive blood transfusions. Persons with immune problems may need special medical care, including treatment with immune globulin (antibodies), to help their bodies get rid of the infection.

There is no universally recommended approach to monitor a pregnant woman who has a documented parvovirus B19 infection. Some physicians treat a parvovirus B19 infection in a pregnant woman as a low-risk condition and continue to provide routine prenatal care. Other physicians may increase the frequency of doctor visits and perform blood tests and ultrasound examinations to monitor the health of the unborn baby. The benefit of these tests in this situation, however, is not clear. If the unborn baby appears to be ill, there are special diagnostic and treatment options available, and your obstetrician will discuss these options with you and their potential benefits and risks.

Antimicrobial regimen

  • Parvovirus B19[1]
  • 1. Erythema infectiosum
  • Supportive therapy: Symptomatic treatment only
  • 2. Arthritis/arthalgia
  • Preferred regimen: Nonsteroidal anti-inflammatory drugs (NSAID)
  • 3.Transient aplastic crisis
  • Supportive therapy: Transfusions and oxygen
  • 4. Fetal hydrops
  • Supportive therapy: Intrauterine blood transfusion
  • 5. Chronic infection with anemia
  • Preferred regimen: IVIG and transfusion
  • 6.Chronic infection without anemia
  • Preferred regimen: IVIG
Note (1): Diagnostic tools are IgM and Igb antibody titers.Perhaps better is blood Parvovirus PCR.
Note (2): Dose of IVIG not standardized; suggest 400 mg/kg IV of commercial IVIG for 5 or 10 days or 1000 mg/kg IV for 3 days.
Note (3): Most dramatic anemias in pts with pre-existing hemolytic anemia.
Note (4): Bone marrow shown erythrocyte maturation arrest with giant pronormoblasts.

References

  1. Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.

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