Dawaa Reference

infectious

Erythema Infectiosum (Fifth Disease)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

CDC Parvovirus B19 Guidance · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299)

Verified against2 documents
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

  • The illness often starts with fever, tiredness, muscle aches, diarrhea, vomiting, and headache [diarrhoea · fatigue · fever · headache · muscle pain · vomiting]
  • Joint aches are more common in adults than children, and women report them more than men [joint pain]
  • Sun or heat exposure can flare the rash [rash]
  • It is a febrile illness of children aged 5 to 15, and adults catch it too but less often [fever]
  • Parvovirus B19 is the cause, and the same virus lies behind aplastic anaemia, polyarthropathy and hydrops fetalis [anaemia · hydrops fetalis]
  • Red flag: in pregnancy a transient aplastic crisis or hydrops fetalis needs special consideration [hydrops fetalis]
  • It travels mainly on respiratory droplets, can also travel in the blood, and clusters in spring and early summer

Signs — what you find (7)

  • A bright red rash covers both cheeks with a pale ring around the mouth [pallor · rash]
  • The facial rash typically lasts 4 to 5 days [rash]
  • The trunk and limb rash can fade into a lace-like pattern on extensor surfaces and spares the palms and soles [rash]
  • Joint involvement is usually symmetric, affecting the hands, feet, wrists, knees, and elbows
  • Immunocompromised patients often lack the typical rash or joint findings
  • The child is no longer contagious once the rash appears [rash]
  • The rash moves through 3 distinct phases on the skin [rash]

Tests (4)

  • IgM antibodies confirm a recent infection, appearing 7 to 10 days after exposure
  • IgG antibodies rise about 2 weeks after exposure and indicate lasting immunity
  • Antibody testing helps confirm parvovirus B19 as the cause of an aplastic crisis
  • IgG testing in pregnancy checks immunity status and risk to the fetus

If not this — what else fits (4)

  • Other viral rashes to distinguish include measles, rubella, roseola, and scarlet fever
  • In adults with joint pain, influenza and mononucleosis should also be considered
  • Drug hypersensitivity reactions, rheumatoid arthritis, and juvenile idiopathic arthritis are also on the differential
  • Joint-disease diagnoses become unlikely once the pain and stiffness resolve, typically by 3 weeks

SourceStatPearls "Erythema Infectiosum" - disease-level clinical article

Presentation findings are traced to the source above.

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g 3 or 4 times daily (max. 4 g daily)

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(Give 15 mg/kg every 4-6 hours as needed (max 60 mg/kg/day) Under 1 month: 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg/day (MSF Essential Drugs 2024).)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Antipyretic and analgesic for the fever and joint discomfort of erythema infectiosum, a self-limiting viral illness; it does not treat the underlying viral infection itself.

Cautions
  • Benign self-limiting viral rash in children; patient is NO LONGER CONTAGIOUS once rash appears.
  • PREGNANCY ALERT: Parvovirus B19 causes hydrops fetalis and fetal loss in pregnant women; urgent obstetric referral required.
  • There is an aplastic crisis risk in patients with chronic haemolytic anaemia (sickle cell, thalassaemia, spherocytosis).
  • 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case.
  • Administer with caution to patients with hepatic impairment.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP
2

IBUPROFEN

add-on - not a substitute

Strength400 mg

Formoral.solid

Adult dose and duration

400 mg every 8 hours with food as needed for joint pain

Paediatric dose

5-6.67 mg/kg/dose [child max 400 mg]

(Give 5-10 mg/kg 3 times daily with food for symptomatic arthralgia. Daily ceiling: the suspension's own label caps pain- and-fever use at 20 mg/kg/day, while the reference literature allows up to 40. Stay near 20 unless there is a reason to climb, never exceed 400 mg in a single dose, and note that 30-40 mg/kg/day is the juvenile arthritis range rather than an analgesic one.)

Dose by weight
3kg15-20 mg/dose
4kg20-26.7 mg/dose
5kg25-33.4 mg/dose
6kg30-40 mg/dose
7kg35-46.7 mg/dose
8kg40-53.4 mg/dose
9kg45-60 mg/dose
10kg50-66.7 mg/dose
11kg55-73.4 mg/dose
12kg60-80 mg/dose
13kg65-86.7 mg/dose
14kg70-93.4 mg/dose
15kg75-100 mg/dose
16kg80-106.7 mg/dose
17kg85-113.4 mg/dose
18kg90-120.1 mg/dose
19kg95-126.7 mg/dose
20kg100-133.4 mg/dose
21kg105-140.1 mg/dose
22kg110-146.7 mg/dose
23kg115-153.4 mg/dose
24kg120-160.1 mg/dose
25kg125-166.8 mg/dose
26kg130-173.4 mg/dose
27kg135-180.1 mg/dose
28kg140-186.8 mg/dose
29kg145-193.4 mg/dose
30kg150-200.1 mg/dose
31kg155-206.8 mg/dose
32kg160-213.4 mg/dose
33kg165-220.1 mg/dose
34kg170-226.8 mg/dose
35kg175-233.4 mg/dose
36kg180-240.1 mg/dose
37kg185-246.8 mg/dose
38kg190-253.5 mg/dose
39kg195-260.1 mg/dose
40kg200-266.8 mg/dose
41kg205-273.5 mg/dose
42kg210-280.1 mg/dose
43kg215-286.8 mg/dose
44kg220-293.5 mg/dose
45kg225-300.1 mg/dose
46kg230-306.8 mg/dose
47kg235-313.5 mg/dose
48kg240-320.2 mg/dose
49kg245-326.8 mg/dose
50kg250-333.5 mg/dose
Dose source

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Why

Adjunct NSAID added for the polyarthropathy that the causative virus frequently produces in post-pubertal females, giving anti-inflammatory pain relief on top of paracetamol.

Cautions
  • Useful for post-pubertal females who frequently develop polyarthropathy with Parvovirus B19.
  • Take with food.
  • The 400 mg per-dose ceiling comes from the reference literature, not from the suspension label - that label's largest paediatric single dose is 200 mg. Below about 40 kg the weight calculation binds first and the ceiling never comes into it.
  • Contraindicated in the last trimester of pregnancy.
Egyptian brands
Egyptian brandManufacturerIndicative price
DAJUANOFEN 400 MG 20 F.C. TABS.COPAD PHARMA5.00 EGP (0.25/unit)
FLABU 400MG 10 F.C.TAB.DELTA PHARMA3.75 EGP (0.38/unit)
NOVA-PROFEN 400MG 30 F.C. TABLETSSANOFI12.75 EGP (0.42/unit)
IBUPROFEN 400 MG 10 TAB.SEDICO6.00 EGP (0.60/unit)
MAFO 400 MG 30 F.C.TABSEIPICO42.00 EGP (1.40/unit)
BRUFEN 400 MG 30 TABS.KAHIRA > ABBOTT LABORATORIES78.00 EGP (2.60/unit)
PROFUSOL 400MG 20 S.G CAPS.EUROPEAN EGYPTIAN PHARM. IND.31.00 EGP
ANALGIPROF 400 MG 25 SACHETSEVA PHARMA37.50 EGP
NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solidSANOFI2.25 EGP
BRUFEMOL-N SUSP. 60 ML? strength differs? different route - not oral solidARAB DRUG COMPANY (ADCO)4.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.