Which group is more likely to report arthralgias with erythema infectiosum?

• A. Older children and adults
• B. Infants
• C. Neonates
• D. Toddlers

Answer: (A)

Arthralgias from erythema infectiosum (parvovirus B19) are most common in older children and adults, because the joint symptoms reflect an immune-mediated inflammatory response that tends to occur after the adaptive immune system has developed. In school-age children, the infection typically presents with a facial “slapped-cheek” rash and mild illness, with joint pain being uncommon. Adults, on the other hand, frequently develop a symmetric arthritis or arthralgia that can last weeks to months, sometimes mimicking rheumatoid arthritis. Infants and neonates are more at risk for hematologic complications or fetal hydrops if infection occurs during pregnancy, and joint symptoms are not the characteristic presentation. So the group most likely to report arthralgias is older children and adults.