Feb 05, 2012 parvovirus b19 in pregnancy parvovirus is a member of the family parvoviridae. The mortality related to parvovirus b19induced anemia remains higher than that in alloimmunization cases. In south africa, the prevalence of parvovirus b19 infection in the hiv infected population with severe anaemia is not known. Also, a cat or dog cannot catch parvovirus b19 from an infected person. Neurological aspects of human parvovirus b19 infection. In immunocompetent hosts, b19v infection either can be subclinical or can cause a wide spectrum of clinical manifestations such as erythema infectiosum in children, arthropathy in adults, transient aplastic crisis in patients with hemolytic disorders and nonimmune hydrops during pregnancy. Vernazza et al 23 described persistent b19 infection as an uncommon cause of anemia in these patients, due to preservation of an adequate humoral immune response until the late stages of hiv infection. They are usually mild or asymptomatic, and do not require treatment. Human parvovirus b19 infection in hivpositive patients. Acute parvovirus b19 infection frequently causes false. Oct 11, 2019 parvovirus b19 b19v is a singlestranded dna virus of the family parvoviridae and genus erythrovirus. This is different from the parvovirus seen in dogs and cats, so you cant get the infection from a pet or vice versa. Parvovirus b19 infection workup medscape reference.
Parvovirus b19 infection may affect the development of arthritis. Viral myositis and parvovirus b19 associated myositis should be considered in adults presenting with significant myalgia. Adults can get infected with parvovirus b19 resulting in fifth disease too. The child is not very ill, and the rash resolves in 7 to 10 days. Clinical benefit was observed with a simultaneous loss of biological parvovirus b19 viremia. Parvovirus b19 about human parvovirus b19 fifth disease cdc. The association with a disease was unclear in the first time after the discovery of b19v, but meanwhile, the usually droplet transmitted b19v is. Masayuki nara, yuko shirata, toshiaki kikuchi and michio hongo, adult human parvovirusb19 infection presenting with hearing difficulty and dizziness, the tohoku journal of experimental medicine, 224, 1. Parvovirus b19 infection is globally prevalent and common in childhood.
It can also provoke transient aplastic crises in patients with sickle cell disease or other. A small number of groups, living in remote geographical locations, have not been exposed to human parvovirus. Case of persistent parvovirus b19 infection with bilateral. Primary human parvovirus b19 infection in an hiv infected. Symptoms can include a low fever, cold symptoms, and a headache. Infection a parvovirus b19 et grossesse request pdf. Parvovirus b19 infection in a fatal case of acute liver fail. Neurologic manifestations associated with parvovirus b19. Parvovirus b19 fifth disease fact sheet fact sheets. Parvovirus b19 infection can trigger an acute cessation of red blood cell production, causing transient aplastic crisis, chronic. Fetal anemia is often diagnosed incidentally, and it is almost always severe and associated with fetal hydrops. Diagnosis can also be established by culturing the virus from bone marrow or by elisa detection of the antigen in serum. In the elderly, as many as 90% have antibodies against b19 fields 2372. Parvovirus b19 infection in otherwise healthy children and adults has an extremely low.
Fifth disease is a viral infection caused by parvovirus b19. We report the case of a 54yearold caucasian woman with chronic arthralgia due to persistent parvovirus b19 viremia. Complications t hought to be associated with parvovirus b19 infection include encephalopathy, epilepsy, meningitis, myocarditis, dilated cardiomyopathy, and autoimmune hepatitis footnote 1, footnote 6. Persistent parvovirus b19 viremia with chronic arthralgia. Le parvovirus b19 peut etre responsable dune anemie f. Parvovirus b19 is a virus that can cause a variety of conditions, including fifth disease. These outbreaks are centred around primary schools where up to 40% of pupils may be infected. Patients with iron deficiency anemia, hiv, sickle cell disease, thalassemia, or spherocytosis are at greatest risk. Since its discovery in the 1970s of last century 1, human parvovirus b19 b19 has been linked with a broad spectrum of clinical syndromes, including erythema infectiosum ei, transient aplastic crisis, persistent infection manifesting as pure red cell aplasia in immunocompromised individuals, nonimmune hydrops fetalis, and arthritis. Parvovirus b19 can also spread through blood or blood products. In adults and perhaps some children, parvovirus b19 can lead to a seronegative arthritis which is usually easily controlled with analgesics.
Complications t hought to be associated with parvovirus b19 infection include encephalopathy, epilepsy, meningitis, myocarditis, dilated cardiomyopathy, and autoimmune hepatitis1,6. Arthropathy due to parvovirus b19 infection was first reported in 1985 3, 4. Most outbreaks of parvovirus infection are acquired by direct contact with respiratory secretions and primarily occur in the spring. A substantial proportion of infected adult women may also have arthropathy in association with parvovirus b19 infection woolf et al. Clinical presentation of parvovirus b19 infection in hiv. See clinical manifestations and diagnosis of parvovirus b19 infection and treatment and prevention of parvovirus b19 infection. Parvovirus b19 is a virus that commonly infects humans. Women are approximately twice as likely as men to experience arthritis after parvovirus infection. Prospective study of human parvovirus b19 infection in. We sought to describe the characteristics and outcome of the systemic manifestations of hpvb19.
Many people infected with parvovirus b19 do not have any symptoms, or they have only mild, nonspecific rash illness, not unlike the. The clinical manifestations and diagnosis of parvovirus b19 infection will be discussed here. Servey, lt col sel, usaf, mc, travis air force base, california brian v. Pv b19 infection results in the consistent ablation of erythroid precursors early in the disease course with accompanying reticulocytopenia. Small virus contagious during spring, parvovirus b19 is responsible for fifth disease of children. When checking for a misdiagnosis of human parvovirus b19 infection or confirming a diagnosis of human parvovirus b19 infection, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis.
In some cases, however, infection is associated with sufficiently severe complications that treatment is indicated and may be lifesaving. The ill child typically has a slappedcheek rash on the face and a lacy red rash on the trunk and limbs. But it can cause different signs and symptoms, depending on your age and overall health. The degree of resulting anemia largely depends on the red cell halflife and immune status of the individual. The prevalence of infection is higher during epidemics between 3 and 20% with seroconversion rate of 334% 3,4. A case report on parvovirus b19 associated myositis. Parvovirus b19 home parvovirus b19 and fifth disease cdc. Persistent b19 parvovirus infection in patients infected. Less common symptoms of parvovirus b19 infection include painful or swollen joints polyarthropathy syndrome, which is more common in adults, and severe anemia a. Parvovirus b19 is the cause of fifth disease in children and can trigger transient arthropathy in adults. You can get your pets vaccinated to prevent infection from such parvoviruses. In the immunocom promised host, persistent b19 infection is manifested as pure red cell aplasia and chronic anemia. Parvovirus b19 infection definition of parvovirus b19.
B19v infection is associated with a wide spectrum of clinical. This test is used to assess the presence of and immunity from parvovirus b19 e. Recognition of and therapy for parvovirus in this population will avoid erythrocyte transfusion and should prevent transmission of the virus to other persons, including immunosuppressed persons and women of childbearing age. Parvovirus b19 the face and a lacy red rash on the trunk. Pv infection is usually asymptomatic and causes selflimiting nonspecific symptoms, such as rash, fever, myalgia, and arthralgia in healthy individuals. Parvovirus b19 and the new century clinical infectious. Parvovirus b19 infection presenting with neutropenia and.
Erythropoietin epo levels in a patient with hiv and most anaemias are generally lower for the degree of anaemia and treatment with epo. Human parvovirus b19 b19v is a small singlestranded dna virus, which is responsible, mainly in children, for erythema infectiosum or fifth disease. But b19v infects erythrocyte progenitor cells and thus, acute b19v infection in patients with a high. Common symptoms of parvovirus b19 b19v infection include a mild nonspecific prodromal illness that may consist of fever 1530% of patients.
We present two cases of myositis as a result of parvovirus b19 infection. Erythrovirus b19 is found worldwide and can cause sporadic infection or epidemic outbreaks, with a cyclical pattern of epidemic outbreaks occurring every 25 years. Parvovirus b19 causes exanthem and other clinical syndromes. Pet dogs and cats can get infected with other parvoviruses that do not infect humans. Parvovirus b19 infection should continue to be considered in the differential diagnosis of anemia in hivinfected children. Clinical presentations of parvovirus b19 infection jessica t. Reamy, col, usaf, mc, uniformed services university of the. Parvovirus b19 infection is a mild rash illness that occurs most commonly in children. Clinical presentations of parvovirus b19 infection american family. What is the mortality rate of parvovirus b19 b19v infection. Acute parvovirus b19 infection can be confirmed by a rapid rise and fall of igm antibody. Diagnostic tests for human parvovirus b19 infection including blood tests, urine tests, swabs, diagnostic tests, lab tests, and pathology testing. Once you recover from fifth disease, you develop immunity that generally protects you from parvovirus b19 infection in the future. Acute parvovirus b19 infection frequently causes falsepositive results in epsteinbarr virus and herpes simplex virusspecific immunoglobulin m determinations done on.
Parvovirus b19 is the infectious agent responsible for an illness called fifth disease. The association with a disease was unclear in the first time after the discovery of b19v, but meanwhile, the usually droplet transmitted b19v is known as the infectious agent of the fifth disease, a rather harmless childrens illness. A pregnant woman who is infected with parvovirus b19 can pass the virus to her baby. Most infections are spread by the respiratory route, although spread via contaminated blood is also possible. Baboon syndrome was formerly considered simply as a skin condition. Clinical manifestations and diagnosis of parvovirus b19. Clinical manifestations of parvovirus b19 infection can be divided into three main categories heegaard and hornsleth, 1995. Individuals congenitally lacking p antigen are not susceptible to pv b19 infection. Since parvovirus b19 infects only humans, a person cannot catch the virus from a pet dog or cat.
Infection a parvovirus b19 et grossesse emconsulte. Neurological manifestations of human parvovirus b19 infection. Alternatively, parvovirus b19 infection may manifest with purpuric rash, erythema multiforme, or pruritus of the soles of the feet. Parvovirus b19, the first known parvovirus to cause disease in humans, was discovered in london by australian virologist yvonne cossart in 1974. Human parvovirus infection is most common among elementary schoolage children during outbreaks in the winter and spring months, but anyone can become ill with it anytime of. The human parvovirus b19 causes parvovirus infection.
The microbiology, epidemiology, transmission, pathogenesis, treatment, and prevention of this infection, as well as issues of infection during pregnancy, are discussed elsewhere. In adults, and in women especially, arthralgia is a common manifestation of parvovirus b 19 infection. Schwarz tf, roggendorf m, hottentrager b, deinhardt f, enders g, gloning kp, schramm t, hansmann m. Parvovirus b19 is the causative agent of fifth disease ie, erythema infectiosum, slapped cheek syndrome, which usually produces a mild illness characterized by an intensive erythematous maculopapular facial rash. Most patients were children, and twothirds had central nervous system manifestations. Parvovirus b19 infections american family physician. The aim of this study was to assess the prevalence of parvovirus b19 in a cohort of hiv infected patients with severe anaemia. Classification there are three genotypes within the erythroparvovirus genus. This virus can cause polymorphic skin signs and constitutes a differential diagnosis for rash in baboon syndrome. Parvovirus b19 is the predominant parvovirus pathogen in humans and the prototype genotype 1 strain. What are the signs and symptoms of parvovirus b19 b19v. Systemic manifestations associated with parvovirus b19. Does an intrauterine exchange transfusion improve the fetal.
The five wellestablished syndromes associated with parvovirus b19 are. The clinical presentations associated with b19 infection vary greatly, ranging from benign to life threatening. Acute hepatitis as a manifestation of parvovirus b19 infection. During pregnancy, infection with b19v can be transmitted vertically from mother to fetus in up to 3050% of cases and cause severe fetal complications, such as severe anemia. Primary human parvovirus b19 infection in an hiv patient.
The prevalence of infection is very high before 10 years old and children are especially responsible for transmission to pregnant women. Request pdf infection a parvovirus b19 et grossesse small virus contagious during spring, parvovirus b19 is responsible for fifth disease of children. The failure to produce neutralizing antibodies to the virus following b19 infection in immunodeficient persons may result in persistent viremia. Dogs and cats may be immunised against parvovirus, but these are animal parvoviruses that do not infect humans. Lindblom a, heyman m, gustafsson i, norbeck o, kaldensjo t, vernby a. There are few reports in the literature of hepatitis as a manifestation of parvovirus b19 infection. Parvovirus infection symptoms and causes mayo clinic.
Although parvoviruses commonly cause disease in animals, it was only in 1975 that the first human pathogen of this family was discovered by cossart and colleagues while screening normal blood bank donors sera for the hepatitis antigen one. The clinical presentation is influenced by the infected individuals age and hematologic and immunologic status. Bloom mc, rolland m, bernard jd, fournie a, berrebi a, regnier c. Diagnostic tests for human parvovirus b19 infection. Human parvovirus b19 hpvb19 is well known as a cause of erythema infectiosum during childhood, pure red cell aplasia in immunocompromised persons, transient aplastic crisis in patients with hereditary hemolytic anemia, and hydrops fetalis during pregnancy. Parvovirus b19 associated with pseudoappendicitis sir, parvovirus b 19 infection has been associated with aplastic crisis in patients with chronic haemolytic anaemias and erythema infectiosum fifth disease in children. These alternate diagnoses of human parvovirus b19 infection may already have. If parvovirus b19 infection is suspected in a person who is immunocompromised, has a haematological disorder, or is in early transient aplastic crisis, arrange urgent blood testing for. Does an intrauterine exchange transfusion improve the. Parvovirus b19 infection causes erythema infectiosum, or fifth disease, in normal hosts, aplastic crisis in patients with hemolytic disorders, and chronic anemia in immunocompromised hosts. The age distribution is similar to that observed in the united states. High doses of ascorbic acid treatment were initiated due to the failure of conventional analgesic therapy. Epidemiology of parvoviruses b19 infection, epidemiology of. Hightitre viral dna using pcr analysis, to confirm the diagnosis of parvovirus b19 infection.
Parvovirus b19 most commonly causes fifth disease, a mild rash illness that usually affects children. Persistent infection with parvovirus b19 b19 is an important treatable cause of anemia in hivinfected patients. Infection maternofoetale a parvovirus associee a une peritonite meconiale antenatale. Parvovirus b19 is a widespread infection that may affects 15% of pregnant women, mainly with normal pregnancy outcome 1,2.
Acute parvovirus b19 infection is suggested to be involved in the pathogenesis of some ht cases. Parvovirus b19 dna was detected by polymerase chain reaction in the brain. Our case was linked to a primary parvovirus b19 infection. Approximately 50% of women old enough to procreate have stigmas serologic of old infection. Parvovirus b19 may cause a papularpurpuric glovesandsocks syndrome ppgss, which manifests as an erythematous exanthem of the hands and feet with a distinct margin at the wrist and ankle joints. Cossart and her group were focused on hepatitis b and were processing blood samples when they discovered a number of false positives later identified as parvovirus b19. Adults developing primary human parvovirus b19 b19 infection may present with arthralgia, fever, and maculopapular rash. About 50% of adults have igg antibodies against the virus which persist in the blood stream for life after an infection with b19, suggesting a previous infection. Symptomatic parvovirus b19 infection associated with severe chronic anemia is an uncommon problem in hivinfected children who live to up to 2 years of age and are not severely immunocompromised. Aug 15, 2005 human parvovirus b19 causes erythema infectiosum and is associated with arthritis, fetal death, and transient aplastic crisis, as well as persistent infection in immunocompromised persons, in whom it manifests as chronic anemia. Infection a parvovirus b19 et grossesse sciencedirect. We describe a case of parvovirus b19 associated acute hepatitis diagnosed based on a positive serologic test igm and molecular detection of parvovirus b19 dna in a liver biopsy specimen.
Parvovirus b19 infection also known as fifth disease, slapped cheek, slapped face, erythema infectiosum including symptoms, treatment and prevention. This emedtv article takes an indepth look at this virus, including information about how it is transmitted, the various conditions it can cause, and more. Infection during pregnancy can cause a variety of other signs of fetal damage. Pv is also known to cause a variety of hematological manifestations. It most commonly causes fifth disease, a mild rash illness that usually affects children. Parvovirus b19related anemia in hivinfected patients aids. While antiparvovirus igm develops one to two weeks after initial exposure, igg appears a few weeks later and increases during the active phase of infection and stabilizes after recovery. Parvovirus b19 b19v is a singlestranded dna virus of the family parvoviridae and genus erythrovirus. In immunosuppressed patients, including those with hiv infection, such humoral responses are impaired and severe chronic bone marrow suppression and arthritis may occur. Some 50% of children and 6090% of adults are seropositive. Parvovirus b19 infection can trigger an acute transient aplastic crisis or chronic red cell aplasia. Recovery is linked to the development of specific neutralising antibodies. The b19 parvovirus is a remediable cause of severe chronic anemia in hivinfected patients.
426 1651 334 645 395 1511 1557 25 474 248 77 1069 1004 317 1569 124 422 82 1493 208 1575 842 1342 1436 120 405 1221 1194 866 1311 646 245 249 522 278 1281 854 1466 1416 668 348