Fifth disease natural history, complications and prognosis

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

Overview

Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Occasionally, serious complications like hydrops fetalis may develop from parvovirus B19 infection during pregnancy.

Natural History

  • Fifth disease is usually a mild illness that resolves on its own among children and adults who are otherwise healthy. Joint pain and swelling in adults usually resolve without long-term disability.
  • Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic hemolytic anemia. In such persons, parvovirus B19 can cause an acute, severe anemia. Once the infection is controlled, the anemia resolves. Furthermore, persons who have problems with their immune systems may also develop a chronic anemia with parvovirus B19 infection that requires medical treatment. People who have leukemia or cancer, who are born with immune deficiencies, who have received an organ transplant, or who have human immunodeficiency virus (HIV) infection are at risk for serious illness due to parvovirus B19 infection.

Complications

  • There are generally no complications in normally healthy children.
  • Usually, there is no serious complication for a pregnant woman or her baby because of exposure to a person with fifth disease. Occasionally, serious complications may develop from parvovirus B19 infection during pregnancy.
    • Infection in the first trimester has been linked to hydrops fetalis, causing spontaneous abortion.
    • Sometimes, however, parvovirus B19 infection will cause the unborn baby to have severe anemia. This occurs in less than 5% of all pregnant women who are infected with parvovirus B19 and occurs more commonly during the first half of pregnancy.
  • Severe anemia in persons with sickle-cell disease: The ill person may be pale, weak, and tired, and should see his or her physician for treatment. (The typical rash of fifth disease is rarely seen in these persons.)

Prognosis

  • Patient generally recover fully from the illness.

References


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