Parvovirus B19

Background

• In children: causes Erythema infectiosum (Fifth disease)
• In transplant patients on immunosuppressive drugs: causes RBC aplasia.
  • Short-lived, may not be discovered
  • Parvovirus only replicated in erythroid progenitor cells

Clinical Features

• Erythema infectiosum (fifth disease)
• Most contagious during the phase of active viral replication and viral shedding, which occurs approximately 5 to 10 days after exposure and usually lasts approximately 5 days
• Complications
  • Arthropathy
  • Aplastic anemia

Differential Diagnosis

• Roseola
• Measles
• Rubella
• Enteroviral infections
• Group A Streptococcal infections

Evaluation

• Diagnosis is clinical usually through clinical presentation
• IgM testing is recommended for immunocompromised patients.

Management

• Parvovirus is usually self-limiting and requires no further treatment.
• Management should be targeted at reducing symptoms, such as using anti-inflammatory medications for arthropathy or performing transfusions for aplastic anemia.

References

• Fish RM, Massad MG. The Transplant Patient. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011.
• Place R, Lagoc AT, Mayer TA, Lawlor CJ. Oncology and Hematology Emergencies in Children. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011

Authors

Ross Donaldson