PEDIATRICS
SYMPTOMS/EXAM
■ Characteristic“slapped cheek”rash, with progression to a lacy macu-
lopapular rash (often pruritic) starting on the upper extremities and then
generalizing (see Figure 5.11)
■ Usually afebrile
■ Arthralgias and arthritis occur in only 10% of children but commonly
occur in adults.DIAGNOSIS
■ Clinical diagnosis
■ Serologic confirmation only in select casesTREATMENT
Supportive careCOMPLICATIONS
Aplastic crisiscan occur in patients with chronic hemolytic anemias, sickle
cell disease, or HIV infection.ROSEOLAINFANTUM(EXANTHEMSUBITUM)Caused by HHV-6 (human herpesvirus 6)SYMPTOMS/EXAM
■ Rapid onset of high fever (often up to 104.9°F) in an otherwise well-
appearing child with few symptoms
■ After 2–4 days of fever, the child becomes afebrile.
■ Rash usually appears after fever resolves.
■ Typical rash consisting of discrete, small, blanching maculopapules appears
starting on the trunk and spreading to the periphery (see Figure 5.10).TREATMENT
Supportive care and antipyreticsVARICELLACHICKENPOXVaricella chickenpox is a herpes virus infection. The reactivation syndrome is
known as zoster (shingles, herpes zoster).SYMPTOMS/EXAM
■ Low-grade fevers <39°F for the first few days, but may be afebrile
■ Characteristic pruritic rash starts on the trunk and spreads to extremities.
The rash begins as papules, which evolve into vesicles on an erythematous
base (“dewdrops on a rose petal”) and pustules over the course of 6–8
hours, with new crops occurring every 2–4 days (see Figure 5.12).DIAGNOSIS
Clinical diagnosis, although varicella virus can be recovered from vesicular
lesions