Red cheeks and rashes : An allergy or an infection?On March 23, 2019 by Ronald S. White
The kid’s cheeks look like they’ve been spanked by someone and there’s a fancy rash on their body? What is that? Is it an allergy or an infectious disease? It’s most likely a parvovirus infection.
Parvovirus: what’s the pathogen?
Parvovirus B 19 is widespread all over the world. It infects almost every person in their lifetime. Most often the first encounter with the pathogen is in childhood, when the clinical picture of the disease unfolds. The most striking manifestation of the infection is the skin rash, causing a lot of anxiety in parents. By the way, in the period of rashes the patient is considered non-communicable. But in the incubation period of the disease it may well infect those who have not yet been ill.
The incubation period itself is quite long (4-28 days, 16-17 days on average), so somehow to protect against infection is difficult. The exciter belongs to the family of parvoviruses, a genus of erythroviruses. It is noted that the epidemiological rise in morbidity occurs every 4-6 years. It is difficult to say how often the disease occurs, because very often it is not registered, and there is no epidemiological supervision over it at all in our country.
However, parents should know its main clinical manifestations, so as not to get confused and properly assess the situation. Diagnosis from the mouth of the doctor may sound different: parvovirus infection, erythema infection, “fifth disease”, the disease of “patched cheeks”. These are different terms for the same disease. Lab tests to confirm the diagnosis are rarely performed. As a rule, a typical clinical picture is enough for a doctor to make a diagnosis.
How does infection occur in children
Children of preschool and primary school age are the most frequently ill. Some have symptoms of the disease that are also present in other respiratory infections: increased body temperature, moderate sore throat, increased lymph nodes on the neck, muscle pain, thinning stools. This is typical for the prodromal period of the disease, which lasts 4-7 days.
But the most significant symptom, which allows suspecting the course of the child’s parvovirus infection, is the skin rash. It appears after the prodromal period is over. The rash in this disease is unusual. More than 60% of children have a bright red cheeks on the overall pale background. It appears suddenly and does not bother the child.
More often than not, parents take the hyperemia as an allergic reaction and try to remember what dietary errors were the day before. Redness of the cheeks is moderately pronounced (as if the child came from frost), and maybe very strong (as if after a slap).
The first reaction of parents to such a rash is to give an antihistamine (anti-allergic drug), but there is no effect from it. On the contrary, the rash is not only preserved on the cheeks, but also goes on the body. There rashes have a fancy lace (mesh) shape, usually located on the arms and legs, but may be in other places. The skin to the touch is hot.
Some patients experience moderate skin itching. In some cases, hemorrhagic elements of the rash (by the type of small hemorrhages) are noted. Palms and feet remain clean, and soles may itch.
On average, the rash is kept on the body for 5-7 days, after which it disappears without a trace, leaving no stains or peeling. It is noticed that after a stay in the sun, a hot bath or physical activity, rashes become brighter. Should we treat a vapour infection in children? As a rule, the disease is easy and does not require special treatment. Otherwise, it may be necessary to take antipyretic medication as well as local treatment of yawning inflammation (rinsing, antiseptic sprays).
Sometimes doctors prescribe antiviral drugs, but most patients can do without them. In any case, even if the child is feeling well, it is worth calling a doctor at home to assess his condition, confirm the diagnosis, give recommendations.
For whom the infection is most dangerous
In people with a good immune system, parvovirus infection is easy and without consequences. But in patients with immunodeficiency, the disease may have the following features: joint damage (in symptoms similar to rheumatoid arthritis), liver, nervous system, the emergence of marked anemia, thrombocytopenia, neutropenia (decrease in the amount of hemoglobin in the blood, platelets, leukocytes, neutrophils).
By the way, joint pains are very common in adults (especially in women). Parvovirus B 19 is most dangerous for pregnant women. It does not cause malformations in the fetus, but can cause its intrauterine death in case of mother’s disease at an early stage.
If the infection occurs at 13-20 weeks, the fetus may be affected by the type of non-immune dropsy (oedema syndrome), which usually leads to a tragic outcome of pregnancy. If the mother is ill at a later gestational age, the born child may have serious health problems such as: anaemia, carditis, hepatitis and other pathologies due to the current inflammatory process. Fortunately, most adults have antibodies to the parvovirus, so infection is less common among pregnant women.