Atypical rashes in adult human Parvovirus B19 infection; atypical is typical

Abstract

The childhood illness erythema infectiosum (EI) is caused by Parvovirus (PV) B19 with a slapped cheek-like rash and sometimes a lace-like rash on the extremities but cutaneous manifestions in infection in the adult can be atypical. A healthy 38-year-old male office worker and a 32-year-old non-pregnant female kindergarten teacher presented with fever (former; 37.2 °C for 3 days, latter 38.1 °C for 4 days) following a skin rash persisting several days at different times. Both had a non-pruritic rash (Fig. 1, Fig. 2) on the extremities and a painful postauricular lymphadenopathy. PV B19 infection was confirmed in both by a positive enzyme-linked immunosorbent assay (ELISA) result for serum PV B19-specific IgM. Neither had a typical facial rash nor painful joints. Although the man had no history of exposure to PV B19 infection, the woman was exposed to kindergarteners who with PV B19 infection.