AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentEasy
A 5-year-old child presents with a 3-day history of fever, malaise, and a 'slapped-cheek' rash on her face. The rash then spread to her trunk and extremities, appearing as a lacy, reticulated (net-like) pattern. She has no other significant symptoms. Her immunizations are up to date. Which of the following is the most likely diagnosis?
- AErythema infectiosum (Fifth disease).
- BRubella.
- CMeasles.
- DVaricella (Chickenpox).
Show answer & explanationAnswer & explanation
Correct answer: A. Erythema infectiosum (Fifth disease).
The classic 'slapped-cheek' facial rash followed by a lacy, reticulated rash on the trunk and extremities, along with fever and malaise, is pathognomonic for Erythema Infectiosum, also known as Fifth Disease. This condition is caused by Parvovirus B19. Other options have distinct rash patterns and presentations.
Why the other options are wrong
- B. Rubella (German Measles) presents with a milder maculopapular rash that also spreads from face down, but typically lasts only 3 days and is associated with postauricular and occipital lymphadenopathy.
- C. Measles typically presents with a maculopapular rash that starts on the face and spreads downwards, often coalescing, and is preceded by the '3 Cs' (cough, coryza, conjunctivitis) and Koplik spots.
- D. Varicella (Chickenpox) presents with a pruritic, vesicular rash that appears in successive crops, evolving from macules to papules to vesicles and crusts.
Erythema Infectiosum (Fifth Disease)
A common viral illness in children caused by Parvovirus B19, characterized by a distinctive 'slapped-cheek' facial rash followed by a lacy, reticulated rash on the body.
- Caused by Parvovirus B19.
- Classic 'slapped-cheek' rash.
- Lacy, reticulated rash on trunk/extremities.
Memory trick: Fifth's Face: Slapped, Then Lacy Traces