A young child presents with the facial rash shown in the image. Which of the following is the most likely diagnosis?

Question

Accepted Answer

C. Erythema infectiosum. ## Image Findings
*   Bilateral, intensely erythematous rash affecting both cheeks.
*   The rash gives a characteristic "slapped-cheek" appearance.
*   Relative sparing of the perioral area and forehead.
*   The child appears to be an infant or young toddler.

## Diagnosis
**Key Point:** The characteristic "slapped-cheek" appearance on the face of a child is pathognomonic for **Erythema Infectiosum (Fifth Disease)**.

Erythema Infectiosum is caused by **Parvovirus B19**. It typically presents in three stages:
1.  **Prodromal phase:** Mild fever, headache, coryza (often missed).
2.  **Erythematous facial rash:** The classic "slapped-cheek" appearance, as seen in the image, due to intense erythema on the malar eminences, often with circumoral pallor.
3.  **Reticular (lacy) rash:** A few days later, a lacy, erythematous, pruritic rash appears on the trunk and extremities, which can wax and wane for weeks.

## Clinical Relevance
**Clinical Pearl:** Erythema Infectiosum is generally a benign childhood illness. However, it can cause **aplastic crisis** in individuals with chronic hemolytic anemias (e.g., sickle cell disease, thalassemia) due to its tropism for erythroid progenitor cells. It can also cause **hydrops fetalis** if a pregnant woman contracts it, especially in the first trimester.

## High-Yield for NEET PG
**High-Yield:** The classic "slapped-cheek" rash is the most recognizable feature of Erythema Infectiosum.
**Key Point:** Parvovirus B19 is the causative agent. Transmission is primarily respiratory.

## Common Traps
**Warning:** Do not confuse the facial flushing of scarlet fever with the distinct "slapped-cheek" appearance of Fifth disease. Scarlet fever typically has a more diffuse, sandpaper-like rash and prominent circumoral pallor, but the cheeks themselves are not usually as intensely and sharply demarcated as in Fifth disease.

## Reference
[cite:Nelson Textbook of Pediatrics, 21st Edition, Chapter 262: Parvovirus B19]

Answer

A. Measles

Answer

B. Scarlet fever

Answer

D. Roseola infantum

A young child presents with the facial rash shown in the image. Which of the following is the most likely diagnosis?

Explanation

Image Findings

Diagnosis

Differential Diagnosis

Clinical Relevance

High-Yield for NEET PG

Common Traps

Reference

Practice similar questions

Join our NEET PG community

Feature	Erythema Infectiosum (Fifth Disease)	Scarlet Fever	Measles (Rubeola)	Roseola Infantum (Sixth Disease)
Causative Agent	Parvovirus B19	Streptococcus pyogenes (Group A Strep)	Measles virus	HHV-6, HHV-7
Rash Appearance	"Slapped-cheek" facial rash, followed by lacy rash on trunk/limbs.	Diffuse erythematous, "sandpaper" rash, circumoral pallor, strawberry tongue.	Maculopapular, confluent rash starting on face/behind ears, spreading downwards.	High fever for 3-5 days, then rash appears as fever breaks (trunk to extremities).
Prodrome	Mild, often asymptomatic.	Sore throat, fever, headache.	Cough, Coryza, Conjunctivitis (3 Cs), Koplik spots.	High fever, often without other symptoms.
Image Findings	Matches the "slapped-cheek" appearance.	Does not show diffuse sandpaper rash or typical circumoral pallor.	Does not show generalized maculopapular rash or Koplik spots.	Rash appears after fever breaks, typically on trunk.