Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation Treatment specialist Home Care congestion diarrhea pain and fever sore throat warning signs Outlook Underlying Cause Transmission pregnancy Anatomy

Fifths Disease Home Care

Home care for erythema infectiosum includes:

Fifths Disease Congestion

Home treatment measures for congestion due to erythema infectiosum include general measures and medications. Medications include oral decongestants, decongestant nasal sprays and antihistamines.

General Measures

  • Ask your child to blow the nose gently. Forceful blowing can cause pain and bleeding.
  • Apply petroleum jelly to the nostrils if the skin becomes dry.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Use saline (saltwater) nose spray, such as Ocean Nasal Mist: saline helps to keep the lining of nasal passages moist.

Oral Decongestants
Oral decongestants, such as pseudoephedrine (Sudafed), help to thin the mucus responsible for the congestion. Decongestants are safe for children more than 6 years old. Talk to your doctor before providing a decongestant to a child less than 6 years old.

Decongestant Sprays
Decongestant nasal sprays, such as pseudoephedrine (Afrin), can relieve congestion faster than oral medications, but should not be used in children less than 12 years old.

Examples include:
  • Afrin Nasal Spray
  • Duration Nasal Spray
  • Four-Way Fast Nasal Spray
  • Neo-Synephrine Nasal Spray
  • Vicks Sinex Nasal Spray

Precautions include:
  • Do not use decongestant nasal sprays for longer than 3 days. After three days, the nasal tissues become dependent on the medication. When the medication is stopped, the nasal tissue swells and congestion worsens.

Antihistamines, such as diphenhydramine (Benadryl) brompheniramine and chlorpheniramine, dry nasal tissue. Antihistamines are safe for children more than 5 years old. Talk to your doctor before providing an antihistamine to a child less than 5 years old.

Examples include:

Precautions include:

Diphenhydramine Dosing Chart
AgeDoseIntervalMax Daily Dose
2-5 years6.25 mg4-6 hours37.5 mg/day
6-11 years12.5-25 mg4-6 hours150 mg/day
12 and older25-50 mg4-6 hours300 mg/day

Chlorpheniramine Dosing Chart
AgeDoseIntervalMax Daily Dose
Under 6consult your physician
6-11 years2 mg4-6 hours12 mg/day
12 and up4 mg4-6 hours24 mg/day

Fifths Disease Diarrhea

Home treatment of diarrhea in a child with erythema infectiosum includes hydration and dietary therapy.

Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in children include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Additional ORT fluids for older children include:
  • Soft drinks without caffeine
  • Sports drinks (Gatorade)
  • Tea
  • Water

Strategies for breast-fed infants under 6 months include:
  • Continue breast feeding as much as your baby desires.
  • Provide additional ORT fluids to supplement breast milk.
  • If vomiting occurs, provide small amounts of ORT fluids every 30-60 minutes.
  • Prevent diaper rash by changing diapers frequently and apply Vaseline to the skin.
  • Watch for symptoms of dehydration.

Strategies for bottle-fed infants under 6 months:
  • Give your child normal amounts of formula.
  • Provide as much ORT fluids as your baby desires.
  • If vomiting occurs, provide small amounts of ORT fluids every 30-60 minutes.
  • If vomiting occurs, try a lactose-free formula.
  • Prevent diaper rash by changing diapers frequently and apply Vaseline to the skin.
  • Watch for symptoms of dehydration.

Strategies for children over 6 months:

Dietary Therapy
ORT is most important if you have vomiting with the diarrhea. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Potatoes
  • Rice
  • Strained carrots
  • Wheat
  • Yogurt

Items that may worsen diarrhea include:
  • Alcohol
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods junk food
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Fifths Disease Pain and Fever

Common medications used at home for pain and fever in children with erythema infectiosum include:

Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.



Fifths Disease Sore Throat

Home care for a sore throat in a child with erythema infectiosum includes:

Fifths Disease Warning Signs

Notify your doctor if you child has erythema infectiosum and any of the following:

Continue to Fifths Disease Outlook

Last Updated: Dec 10, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Fifths Disease References
  1. Gildea JH. Human parvovirus B19--flushed in face though healthy (fifth disease and more). Pediatr Nurs. 1998 Jul-Aug;24(4):325-9. [9849265]
  2. Mankuta D, Bar-Oz B, Koren G. Erythema infectiosum (Fifth disease) and pregnancy. Can Fam Physician. 1999 Mar;45:603-5. [10099795]
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