First to seventh diseases: discarded diagnoses?

BMJ 2015; 351 doi: (Published 27 July 2015) Cite this as: BMJ 2015;351:h3525
  1. Mitesh Patel, academic foundation year 2, general practice, Hampton Surgery, Solihull,
  2. Rodger Charlton, professor of primary care, University of Nottingham
  1. mpatel59{at}

A mother brought in her 5 year old child with a rash, asking, “Doctor, is this fifth disease?” Good question, but could it be one of the other six, and why are these childhood exanthema diagnostic terms mostly not used, other than “fifth disease”?

Let’s start at the beginning. “First disease” (measles), first scientifically described around the 10th century, is caused by measles virus. A maculopapular rash initially presents on the face and behind the ears. Bluish white Koplik’s spots may be …

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