Infection with parvovirus B19 is most common in children between the ages of 4 and 11. About half the infections are asymptomatic, and many of the remainder cause a non-specific illness of the respiratory tract.1 The most common distinct disease associated with the infection is erythema infectiosum - also known as fifth disease or slapped cheek disease.2 Erythema infectiosum is usually diagnosed clinically only when there is an outbreak of illness with a rash in young children and red cheeks are a prominent feature. Illness with an erythematous rash due to parvovirus B19 infection is worldwide and common, but in the absence of laboratory tests it is often diagnosed as rubella (both rubella and parvovirus B19 infection have a similar seasonality), allergy, or simply a “viral infection.

An arthropathy similar to that seen in rubella may be associated with parvovirus B19 infection. The most common pattern is symmetric arthralgia or arthritis in the small joints of the hands, with the wrists, knees, and ankles affected …