(BMJ)—A 9-yo girl presented w/ a 4-day hx of mild fever and a 2-day hx of rash. Exam: “bathing trunk” distribution of petechial rash. Labs: reduced WBC, platelet, and reticulocyte counts. What’s the dx?
Meningococcemia
Systemic lupus erythematosus
Idiopathic thrombocytopenic purpura
Acute leukemia
Parvovirus B19 infection
You are correct. PCR assay for parvovirus B19 DNA was positive. “Slapped cheek” rash is a more typical presentation of parvovirus B19 infection and usually occurs after the initial viremia phase, but “bathing trunk” distribution or “papular purpuric gloves and socks syndrome” can occur during the initial viremic phase. Rule out meningococcal dz as a priority in any child w/ petechial rash.

BMJ 2019;367:l5723