Erythema Infectiosum (Slapped Cheek Syndrome) Quiz
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Skin is mottled like lace or a fish net
Have a fever
Redness of the skin
Burning sensation in the joints
Cough
Red rashes on cheeks
Not seeing your symptoms? No worries!
What is Erythema Infectiosum (Slapped Cheek Syndrome)?
Fifth disease (erythema infectiosum) is a childhood condition that appears as a bright red rash on your child’s cheeks. It’s nicknamed “slapped cheek disease” because of this rash. A virus called parvovirus B19 causes fifth disease. This virus is common and very contagious. Infected people can spread it through coughing or sneezing. A second rash can appear on the arms, legs, or back.
Typical Symptoms of Erythema Infectiosum (Slapped Cheek Syndrome)
- Red rash over cheeks
- Fever
- Red skin with lace-like pattern
- Cough
- Fever that started after cold or stomach symptoms
- Warmth in the joints
- Hot flashes
- Headache
Diagnostic Questions for Erythema Infectiosum (Slapped Cheek Syndrome)
Your doctor may ask these questions to check for this disease:
- Do you have red rashes on your cheeks?
- Do you have a fever?
- Do you have red skin with a lace-like pattern?
- Do you have a cough?
- Did your fever start after having cold or stomach symptoms?
Treatment of Erythema Infectiosum (Slapped Cheek Syndrome)
Fifth disease isn’t a serious medical condition. Most children do not need any treatment, except for rest to allow the body to fight the infection.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Feb 19, 2025
Following the Medical Content Editorial Policy
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Erythema Infectiosum (Slapped Cheek Syndrome)?
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- My body is hot
- Recurrent fevers
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- Periodic fever (>100.4°F / 38°C)
- Fever then no fever then fever again
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- Remittent fever of 102.2°F / 39°C
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- Stomach was uncomfortable, then had a fever
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- Stomachache and diarrhea before a fever
- Temperature of 102.2°F / 39°C goes up and down
- Barking cough
See full list
Symptoms Related to Erythema Infectiosum (Slapped Cheek Syndrome)
Diseases Related to Erythema Infectiosum (Slapped Cheek Syndrome)
FAQs
Q.
Fifths Disease? Why Your Skin is Red & Medically Approved Next Steps
A.
Bright red cheeks and a lacy rash are classic signs of fifths disease, a usually mild parvovirus B19 infection that is most contagious before the rash and typically improves with rest, fluids, and appropriate fever or pain medicine. There are several factors to consider, including adult joint pain, how long the rash lasts, and when it is safe to return to school or work; see the complete information below. Seek medical care sooner if you are pregnant, have a blood disorder or weakened immune system, or if symptoms are severe, persistent, or suggest anemia; the medically approved next steps, red flags, testing guidance, and prevention tips are outlined below.
References:
* Baka A, Sadek S, Puthalath A, Khouly M, Farhat M, Abbas M, Ghaddar N, Aftimos P. Parvovirus B19 infection: Clinical features, diagnosis, and management. Rev Med Virol. 2022 Sep;32(5):e2380. doi: 10.1002/rmv.2380. Epub 2022 Jul 28. PMID: 35914561.
* Broliden K, Tolfvenstam T, Norbeck O. Parvovirus B19 infections: an update on epidemiology, clinical manifestations, and diagnosis. Expert Rev Anti Infect Ther. 2018 Jan;16(1):15-27. doi: 10.1080/14787210.2018.1408891. Epub 2017 Nov 22. PMID: 29161726.
* Servettaz A, Lefrère F, Le Besnerais M. Parvovirus B19: clinical manifestations and new insights into diagnosis and treatment. Presse Med. 2019 Jan;48(1):71-78. doi: 10.1016/j.lpm.2018.11.002. Epub 2018 Dec 4. PMID: 30522108.
* Wang Y, Zheng Y, Li H. Parvovirus B19 infection in children: Clinical manifestations and management. Front Pediatr. 2023 Aug 15;11:1232845. doi: 10.3389/fped.2023.1232845. eCollection 2023. PMID: 37626359.
* Iacobelli R, Cota C, Fimiani G, De Rosa R, Coppola L, Di Meo L, Perri A, Coppola M. Human Parvovirus B19: New Insights in a Persistent Pathogen. Viruses. 2023 Jun 20;15(6):1398. doi: 10.3390/v15061398. PMID: 37367359.
Q.
Is it Fifth Disease? Why your skin is red and medically approved next steps.
A.
Fifth disease often causes bright red "slapped" cheeks and a lacy rash on the body; in most healthy people it is mild, short-lived, and by the time the rash appears you are usually no longer contagious. Next steps: rest and fluids, consider acetaminophen or ibuprofen for fever or discomfort, avoid close contact with pregnant people until you are sure you are no longer contagious, and seek medical care if pregnant, immunocompromised, have a blood disorder, or if there is persistent fever, severe joint pain, unusual paleness or shortness of breath, or a blistering or bruising rash. There are several factors to consider, and important details on look-alikes, testing, and when to act are below.
References:
* Servey, J. T., & Chang, P. (2020). Parvovirus B19 Infection: A Review of Clinical Manifestations and Therapeutic Options. *Dermatology and Therapy (Heidelberg), 10*(4), 619–631. PMID: 32367332.
* Papp, M., Szekeres-Bartho, J., & Rigó, D. (2023). Human parvovirus B19 infection: an update. *Frontiers in Immunology, 14*, 1269376. PMID: 38046187.
* Young, N. S. (2019). Parvovirus B19. *Clinics in Laboratory Medicine, 39*(1), 1–17. PMID: 30736932.
* Bock, M. J., Møller, B. K., & Christensen, J. J. (2019). Parvovirus B19 Infection in Children and Adults: A Concise Review. *Danish Medical Journal, 66*(12), A6092. PMID: 31782294.
* Cherry, J. D. (2006). Clinical and epidemiologic characteristics of parvovirus B19 (fifth disease) infection. *Current Problems in Pediatric and Adolescent Health Care, 36*(10), 329–350. PMID: 17098522.
Q.
Red “Slapped” Cheeks? Why Your Face Is Breaking Out + Fifth Disease Next Steps
A.
Bright red slapped cheeks with a lacy body rash are often fifth disease from parvovirus B19. It is usually mild in children, most contagious before the rash, and managed with rest, fluids, and fever control; returning to school is typically OK once the rash appears if they feel well. There are several factors to consider, especially pregnancy, blood disorders, weakened immunity, or severe symptoms that need prompt medical care, and adults may have prolonged joint pain; see the complete next steps, red flags, and when to test or call your doctor below.
References:
* Erdman DD, Fischer GB, Lindstrom SL, et al. Human Parvovirus B19. Clin Microbiol Rev. 2021 Mar 17;34(2):e00049-20. doi: 10.1128/CMR.00049-20. PMID: 33731449; PMCID: PMC8093159.
* Bonifield TL, Miller T, Miller MM. Erythema Infectiosum (Fifth Disease). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30725925.
* Corcoran A, Phipps J, Snider C. Fifth Disease: A Concise Review for the General Pediatrician. Curr Pediatr Rev. 2023;19(2):117-124. doi: 10.2174/1573396319666230113114949. PMID: 36648792.
* Skinner SR, Stone KM. Parvovirus B19 infection in pregnancy. Curr Opin Obstet Gynecol. 2021 Apr;33(2):107-111. doi: 10.1097/GCO.0000000000000693. PMID: 33502264.
* Chung YS, Chung MP, Nam YS. Erythema infectiosum in children: an overview of the diagnosis and treatment. J Acute Dis. 2016;5(6):447-450. doi:10.1016/j.joad.2016.08.006. PMID: 27702580.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Servey JT, Reamy BV, Hodge J (Year). Clinical presentations of parvovirus B19 infection. American family physician.
https://pubmed.ncbi.nlm.nih.gov/17304869/Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL (Year). Erythema Infectiosum: A Narrative Review. Current pediatric reviews.
https://pubmed.ncbi.nlm.nih.gov/37132144/Grossman KL, Rasmussen JE (Year). Recent advances in pediatric infectious diseases and their impact on dermatology. Journal of the American Academy of Dermatology.
https://pubmed.ncbi.nlm.nih.gov/2061433/