Slapped Cheek Syndrome

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is slapped cheek syndrome?

Slapped cheek syndrome, also called fifth disease or erythema infectiosum, is a mild infectious condition that occurs mostly in children. It is named for its distinctive facial rash, which resembles slapped cheeks. Slapped cheek syndrome is caused by an infection with parvovirus B19.

Slapped cheek syndrome is usually mild, accompanied by fatigue or cold-like symptoms for a few days, followed by a rash on the cheeks, arms, legs and trunk. The infection is contagious in the early stages of the illness before the rash is present. Many people infected with parvovirus B19 will not experience any symptoms.

Although the infection typically occurs in children, adults who have never been infected with parvovirus B19 are susceptible. Symptoms in adults are similar to those in children, but adults may also have swelling or pain in the joints.

Slapped cheek syndrome can usually be diagnosed by your physician based on the characteristic rash. A blood test is available that can confirm the diagnosis. There is no specific treatment for slapped cheek syndrome, but over-the-counter medications can be taken to reduce the symptoms of fever or pain. There is no vaccine for slapped cheek syndrome, but you can help prevent its spread by taking basic precautions, such as frequent hand washing.

Seek prompt medical care if you are being treated for slapped cheek syndrome but mild symptoms recur or are persistent.Although slapped cheek syndrome is a mild condition, it is important to rule out other similar and potentially more serious conditions. Contact your health care provider if you or your child has symptoms of slap cheek syndrome.

Exposure to slapped cheek syndrome can also be dangerous for pregnant women. Seek prompt medical care if you are pregnant and think you have been exposedto slapped cheek syndrome.

What are the symptoms of slapped cheek syndrome?

Symptoms of slapped cheek syndrome may include fatigue, fever, or joint pain for three to five days, followed in most people by a distinct rash on the cheeks and sometimes the arms, legs or trunk. More rarely, anemia can be associated with slapped cheek syndrome, especially in individuals with other conditions such as sickle cell disease or a weakened immune system.

Common symptoms of slapped cheek syndrome

You may experience slapped cheek syndrome symptoms for several days or weeks. Symptoms of slapped cheek syndrome may include:

Symptoms that might indicate a serious condition

In some cases, slapped cheek syndrome can be a serious condition for people with anemia or immune deficiency or who are pregnant. If you have any of these conditions and are exposed to slapped cheek syndrome, you should be evaluated immediately by a healthcare provider. You should also seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

What causes slapped cheek syndrome?

Slapped cheek syndrome is caused by an infection with parvovirus B19. This virus is contagious and passed from person to person by saliva or mucus. Parvovirus B19 infects only humans, although a different disease with a similar name affects animals. Slapped cheek syndrome is most common in children, and it is also called fifth disease or erythema infectiosum.

Slap cheek syndrome is contagious during the early phase of the illness, before the rash is visible. After exposure to the virus, it may take less than a week to as long as three weeks for symptoms to appear.

What are the risk factors for slapped cheek syndrome?

A number of factors increase the risk of developing slapped cheek syndrome. Not all people with risk factors will get slapped cheek syndrome. Risk factors for slapped cheek syndrome include:

  • Childhood

  • Compromised immune system due to such conditions as HIV/AIDS or other immunodeficiencies, taking corticosteroids, taking immunosuppressants after organ transplant, or cancer and cancer treatment

  • Exposure to groups of children, as in a school or day care setting

  • Sickle cell anemia

  • Spring season

  • Thalassemia

Reducing your risk of slapped cheek syndrome

Slapped cheek syndrome is caused by a virus and is transmitted in droplets of mucus and saliva. Taking simple hygiene measures can help reduce your risk of catching or transmitting the disease. It is most important to wash your own and your child’s hands frequently.

You may be able to lower your risk of slap cheek syndrome by:

  • Avoiding close contact with children who are ill

  • Not touching your eyes, nose or mouth

  • Washing your own and your child’s hands frequently

How is slapped cheek syndrome treated?

There is no vaccine for slapped cheek syndrome, and there is no specific treatment for the condition. Symptoms of slap cheek syndrome, such as fever or pain, can be treated with over-the-counter pain medications, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). For some individuals, cessation of immunosuppressive therapy has helped them clear chronic infections. In pregnant women, infection before 20 weeks gestation warrants referral to a maternal-fetal medicine specialist.

What are the potential complications of slapped cheek syndrome?

Slapped cheek syndrome is usually very mild. Certain groups of people are more prone to developing complications of slapped cheek syndrome.

If a pregnant woman is infected with the virus that causes slapped cheek syndrome, her baby may have birth defects. Slapped cheek syndrome may cause severe, even life-threatening, anemia in people with a compromised immune system as a result of HIV/AIDS, medications to suppress the immune system after an organ transplant, cancer or cancer treatment, or taking corticosteroids. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of slapped cheek syndrome include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 20
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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