Match each clinical presentation of a pediatric exanthem with its most likely causative viral pathogen.
- A 5-year-old child presents with bright red, confluent erythema on both cheeks, followed by a lacy, reticular rash over the trunk and extremities.Parvovirus B19
- A 14-month-old toddler experiences 3 days of high fever. As the fever abruptly resolves, a blanching, pink maculopapular rash appears on the trunk.Human herpesvirus 6 (HHV-6)
- A 6-year-old child develops a highly pruritic rash. The lesions consist of macules, papules, clear vesicles on an erythematous base, and crusted scabs, all present simultaneously.Varicella-zoster virus (VZV)
- A 3-year-old child presents with low-grade fever, painful oral ulcerations on the posterior pharynx, and small grayish vesicles on the palmar and plantar surfaces.Coxsackievirus type A
Answer
The presentations correspond to Parvovirus B19 (slapped cheek and reticular rash), HHV-6 (rash after fever resolution), VZV (multi-stage pruritic vesicles), and Coxsackievirus type A (vesicles on hands, feet, and oral mucosa).
Each classic pediatric exanthem has pathognomonic features that allow for clinical diagnosis: Parvovirus B19 causes Erythema infectiosum ('slapped cheeks' and lacy rash), HHV-6 causes Roseola (fever breaks then rash appears), VZV causes Chickenpox (asynchronous lesions in various stages of healing), and Coxsackievirus causes Hand, foot, and mouth disease.
Step-by-Step Solution
Key Concept
Clinical diagnosis of common pediatric viral exanthems