Infectious Disease Compendium

Parvovirus B19

Microbiology

A virus.

Epidemiologic Risks

Life. Can't live without it. Half of 15 year olds are seropositive (but which half?). Spread by respiratory droplets and highly infectious. Incubation is around a week.

Syndromes

- Fifths disease (aka slapped cheek): Fevers and a face rash in children. There were 6 childhood rashes. This was the 5th on the list.

- Anemia: Parvovirus kills red cell stem cells (and I have seen it wack WBC's as well). If the patient relies on increased red cell output to maintain their HCT (ex: sickle cell) they can become acutely anemic. Treatment is supportive.

AIDS patients can get severe refractory anemia with a parvovirus infection as they do not make antibody. AIDS patients are seronegative and the diagnosis is made by bone marrow biopsy that shows giant pronormoblasts or PCR on blood for parvovirus.

- In transplant patients, acute Parvovirus B19 can cause a pancytopenia and can only be diagnosed with PCR (PubMed).

- Hydrops fetalis: anemia in the fetus.

- Polyarticular small joint arthritis: in the adult.

- Rarely encephalitis (PubMed), meningitis, stroke, pneumonia, and peripheral neuropathy (PubMed).

"The most common manifestations were joint (80%) and skin (60%) involvement. Four patients (16%) had renal involvement (endocapillary proliferative or membranoproliferative glomerulonephritis, focal segmental glomerulosclerosis). Three patients (12%) had peripheral nervous system involvement (mononeuritis, mononeuritis multiplex, Guillain-Barré syndrome) and 2 (8%) presented muscle involvement. Other manifestations included hemophagocytic lymphohistiocytosis (n = 1), myopericarditis and pleural effusion (n = 1), and lymphadenopathy and splenomegaly mimicking lymphoma with spleen infarcts (n = 1). Immunological abnormalities were frequent (56.5%) (PubMed)."

Diagnosis

Serology and PCR.

Treatment

None for normal hosts. The treatment for AIDS and transplant patients is IVIG 0.4 g per kg for 5 to 10 days (PubMed); they may relapse and require repeat treatment; may also get Fifths with the IVIG.

Notes

It was discovered on position 19 on plate B.

The dog parvovirus is a different virus.

Last update: 07/15/18