Fever may be "saddleback", with remittance at 4 to 8 days followed by recrudescence for 2 weeks
Arthritis is typically a symmetrical polyarticular arthritis that involves small joints and knees
Resolves over months to a year (sometimes longer), but arthralgias (± arthritis) can persist for years
Rash is macular or maculopapular, and more often central but can involve palms and soles
Other common symptoms include headache, fatigue, nausea, vomiting, and conjunctivitis
Bloodwork shows leukopenia, thrombocytopenia, hypocalcemia, and mild to moderate transaminase elevation
Children are more likely to develop neurological symptoms (status epilepticus, complex seizures, and encephalitis) and dermatologic symptoms (bullous rash)
