Erythema Infectiosum Research Articles

Parvovirus B19 in Pregnancy-Do We Screen for Fifth Disease or Not?

Parvovirus B19 (B19V) infection is the cause of erythema infectiosum, or the "fifth disease", a widespread infection, potentially affecting 1-5% of pregnant women, in most cases without significant damage to the pregnancy or fetus. It follows a seasonal variation, with a higher prevalence in temperate climates, mainly in late winter and early spring. Women at increased risk include mothers of preschool and school-age children, and those working in nurseries, kindergartens, and schools. Vertical transmission occurs in 33% to 51% of cases of maternal infection. Parvovirus infection is an important cause of fetal perinatal infection resulting in increased morbidity through the development of fetal anemia, heart failure, and non-immune hydrops. A comprehensive literature review was conducted using PubMed, Cochrane Library, and Google Scholar, focusing on publications from the last 10 years and prioritizing studies related to parvovirus B19 infection in pregnancy. We summarized the existing data in the literature on the effects of parvovirus B19 infection during pregnancy and weighed if there is a need for screening in pregnant patients. Routine screening for parvovirus B19 infection can be considered in communities where infection is common, there is occupational exposure, or during endemic periods, with the reason being that accurate identification and treatment of fetuses affected by congenital B19V infection have been shown to improve perinatal outcomes.

Petechial and Purpuric Rashes During a Parvovirus B19 Outbreak: Are Skin Symptoms Differentiated?

Human parvovirus B19 typically causes erythema infectiosum, but unusual exanthems and hemorrhagic manifestations, such as purpuric-petechial rashes, have also been reported. PVB19-associated purpuric-petechial eruption (PAPPE) should be recognized as a distinct clinical feature of primary parvovirus B19 infection and considered in the differential diagnosis of patients with febrile purpura. This report aims to highlight several scenarios of B19V-associated petechial and purpuric rashes, which may present to pediatric departments during outbreaks.

Erythema Infectiosum: A Narrative Review.

Erythema infectiosum occurs worldwide. School-aged children are most often affected. Since the diagnosis is mainly clinical, physicians should be well-versed in the clinical manifestations of erythema infectiosum to avoid misdiagnosis, unnecessary investigations, and mismanagement of the disease. The purpose of this article is to familiarize physicians with the wide spectrum of clinical manifestations and complications of erythema infectiosum associated with parvovirus B19 infection. A search was conducted in July 2022 in PubMed Clinical Queries using the key terms "Erythema infectiosum" OR "Fifth disease" OR "Slapped cheek disease" OR "Parvovirus B19". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Erythema infectiosum is a common exanthematous illness of childhood caused by parvovirus B19. Parvovirus B19 spreads mainly by respiratory tract secretions and, to a lesser extent, the saliva of infected individuals. Children between 4 and 10 years of age are most often affected. The incubation period is usually 4 to 14 days. Prodromal symptoms are usually mild and consist of lowgrade fever, headache, malaise, and myalgia. The rash typically evolves in 3 stages. The initial stage is an erythematous rash on the cheeks, with a characteristic "slapped cheek" appearance. In the second stage, the rash spreads concurrently or quickly to the trunk, extremities, and buttocks as diffuse macular erythema. The rash tends to be more intense on extensor surfaces. The palms and soles are typically spared. Central clearing of the rash results in a characteristic lacy or reticulated appearance. The rash usually resolves spontaneously within three weeks without sequelae. The third stage is characterized by evanescence and recrudescence. In adults, the rash is less pronounced than that in children and is often atypical. Only approximately 20% of affected adults have an erythematous rash on the face. In adults, the rash is more frequently found on the legs, followed by the trunk, and arms. A reticulated or lacy erythema is noted in 80% of cases which helps to distinguish erythema infectiosum from other exanthems. Pruritus is noted in approximately 50% of cases. The diagnosis is mainly clinical. The many manifestations of parvovirus B19 infection can pose a diagnostic challenge even to the best diagnostician. Complications include arthritis, arthralgia, and transient aplastic crisis. In most cases, treatment is symptomatic and supportive. When parvovirus B19 infection occurs in pregnant women, hydrops fetalis becomes a real concern. Erythema infectiosum, the most common clinical manifestation of parvovirus B19 infection, is characterized by a "slapped cheek" appearance on the face and lacy exanthem on the trunk and extremities. Parvovirus B19 infection is associated with a wide spectrum of clinical manifestations. Physicians should be aware of potential complications and conditions associated with parvovirus B19 infection, especially in individuals who are immunocompromised, chronically anemic, or pregnant.

High risk of misclassification of acute Parvovirus B19 infection into a systemic rheumatic disease.

Parvovirus B19 most frequently causes epidemics of erythema infectiosum in children but also affects adults often leading to rheumatologic manifestations. While the serum profile allows the diagnosis, manifestations may mimic autoimmune conditions. The aim was to evaluate the proportion of patients with acute Parvovirus B19 infection fulfilling classification criteria for rheumatic diseases (RA and SLE). We evaluated the clinical and serological features of 54 patients diagnosed with acute Parvovirus B19 infection seeking rheumatological attention between March and June 2024. The majority of patients were females (78%), with a mean (s.d.) age of 45 (13) years and 54% could not recall any known exposure. Fifty-one/54 (94%) had arthralgia, 27 (50%) arthritis (oligoarthritis in 67% of them), 24 (44%) fever, 19 (35%) skin rash and 7 (13%) purpura. Symptoms resolution generally occurred within 6 weeks. Complement levels were low in 14/33 (42%) tested patients, while the presence of serum ANA, anti-dsDNA, anti-phospholipids and rheumatoid factor was detected in 21/38 (55%), 10/26 (38%), 6/12 (50%) and 5/37 (13%) patients, respectively. Classification criteria for SLE were fulfilled in 93% of ANA-positive patients and RA criteria in 38% of patients with arthritis. Parvovirus B19 infection manifestations may vary and nearly all patients with positive serum ANA fulfil the classification criteria for SLE. The risk of misclassification in patients with viral infection should not be overlooked.

New exanthematous desease in pediatrics

Exanthems do not represent a disease per se, but they are the most clinically useful manifestation for the arrival of the diagnosis of the disease for the physician, as well as the most common cause that brings patients to the consultation. Regarding new pediatric exanthems, it is important to consider the age of onset since they tend to manifest after the first year of the individual's life, while up to 12 months, their epidemiology is usually limited to the well-known classics such as measles, sudden rash, rubella, chickenpox, Kawasaki disease, Coxsackie virus, meningococcemia, echovirus, among others. (1) Classic exanthematous diseases have been known for a long time and have been classified in sequential order. The first and second refer to scarlet fever and measles. Rubella is the third. The exanthem caused by staphylococcal epidermolytic toxin is the fourth. Erythema infectiosum is the fifth, and sudden rash is the sixth disease. In recent decades, new tools and methodologies based on four forms of investigation through clinical studies, laboratory studies, epidemiological studies, and clinical trials including the validation of new and more specific diagnostic criteria, such as procedures for the detection of viral genetic sequences such as PCR, viral load, and antibody affinities, as well as exhaustive epidemiological analyses in patient groups of different ages, nationalities, and skin types, have led to the diagnosis of new exanthematous diseases known as pityriasis rosea (PR), Gianotti-Crosti syndrome (GCS), asymmetric periflexural exanthem/unilateral laterothoracic exanthem (APE/ULE), gloves and socks syndrome (PPGSS), eruptive pseudoangiomatosis (EP), and eruptive hypomelanosis (EH). (2) Background:(Complete here). Material and methods: (Different case repot were analyzed in relation to the available literature in virtual libraries such as PubMed and cited by the Argentine Society of pediatrics). Results: (The systematic review of new rashes manifested mostly in the pediatric population increasingly suggest their viral etiology as well as their low risk of serious systemic complications. Determining their characteristics, chronology and topography as well as the physician´s experience shead diagnostic light on daily clinical practice). Conclusion: (The epidemiological and histopathological analysis of the lesion and clinical methods of diagnosing these rashes has been intense over the past 30 years, although their observation remains key to the increasingly accurate determination of their etiology, which is still subject to refinement and discussion

Role of clinical, molecular, and serological features in the diagnosis of parvovirus B19 infection in children

Parvovirus B19(B19) is a DNA virus. The most common B19 disease is erythema infectiosum (fifth-disease). PCR and ELISA are sensitive for detecting of acute disease. However, it is not clear which test better and the relationship between laboratory tests and clinical findings. To discuss the clinical and laboratory characteristics of pediatric patients infected with B19. 236 children were examined. Children with at least one positive molecular or serological test were included. Positive serum B19-DNA and/or B19-IgM was considered an acute B19 infection. B19DNA was detected in 80.8 % of acute cases. Serological tests were less positive. Acute B19 infection was observed in 24 patients. Only 17 patients were positive for B19 DNA, 3 for IgM and 4 for both. The sensitivity of B19 DNA is 87.5 %. However, this rate is 29.2 % for B19 IgM. B19-DNA and IgM together provide a better, highly accurate diagnosis.

Parvovirus B19 Infection and Pregnancy: Review of the Current Knowledge.

Parvovirus B19, a member of the Parvoviridae family, is a human pathogenic virus. It can be transmitted by respiratory secretions, hand-to-mouth contact, blood transfusion, or transplacental transmission. Most patients are asymptomatic or present with mild symptoms such as erythema infectiosum, especially in children. In rare cases, moderate-to-severe symptoms may occur, affecting blood cells and other systems, resulting in anemia, thrombocytopenia, and neutropenia. Non-immune pregnant women are at risk for fetal infection by parvovirus B19, with greater complications if transmission occurs in the first or second trimester. Infected fetuses may not show any abnormalities in most cases, but in more severe cases, there may be severe fetal anemia, hydrops, and even pregnancy loss. Maternal diagnosis of intrauterine parvovirus B19 infection includes IgG and IgM antibody testing. For fetal diagnosis, PCR is performed through amniocentesis. In addition to diagnosing the infection, it is important to monitor the peak of systolic velocity of the middle cerebral artery (PVS-MCA) Doppler to assess the presence of fetal anemia. There is no vaccine for parvovirus B19, and fetal management focuses on detecting moderate/severe anemia by fetal PVS-MCA Doppler, which, if diagnosed, should be treated with intrauterine transfusion by cordocentesis. Prevention focuses on reducing exposure in high-risk populations, particularly pregnant women.

Нетипичные проявления сыпи у ребенка, инфицированного парвовирусом В19

Erythema infectiosum is the main clinical variant of infection associated with parvovirus B19 in children. Clinical symptoms include mild fever, erythema on the cheeks («a slapped face» symptom), and a maculopapular rash on the body that becomes lacy over time. But this characteristic of the rash is not always recorded. Parvovirus B19 is associated with various skin lesions that require a differential diagnosis with tick-borne borreliosis, sudden exanthema, hemorrhagic vasculitis, systemic lupus erythematosus, etc. The differential diagnosis is considered using the example of a 6-year-old child hospitalized in an Infectious Hospital with atypical manifestations of erythema infectiosum.

Менингит, ассоциированный с парвовирусом В 19 у ребенка

Damage to the nervous system is not typical for parvovirus infection, however, reports of such observations are becoming more and more widespread. We describe a case of meningitis associated with B19 parvovirus in an eight-month-old child without hematological diseases and immunodeficiency, which occurred simultaneously with staphylococcal enterocolitis. The diagnosis was made based on the detection of parvovirus B19 DNA in the cerebrospinal fluid and antibodies (Ig M) in the blood. Clinical symptoms were sparse, and the classic meningitis syndrome complex was not observed. There were also no typical manifestations of erythema infectiosum. Treatment included the administration of intravenous immunoglobulin and a short course of glucocorticosteroids. Recovery occurred 20 days after the disease onset. Observation for a month after discharge from the hospital did not show significant deviations in the child’s health.

Case Report - Parvovirus B19 Pure Red Cells Aplasia after Kidney Transplantation

Parvovirus B19, a member of the Parvoviridae family, is known for causing various clinical manifestations, including erythema infectiosum and arthropathy. However, its association with pure red cell aplasia (PRCA) following solid organ transplantation remains relatively uncommon. We present a case report detailing the occurrence of Parvovirus B19-induced PRCA in a patient who underwent kidney transplantation – a 48 years old man who had history of hypertension and gout who received a kidney from living donor. The patient presented in the clinic with severe anemia, dizziness, headache and swollen lymph nodes which later on was proved to be result from the viral infection. This case underscores the importance of considering Parvovirus B19 as a potential etiological factor in the development of PRCA post-kidney transplantation. Clinicians should maintain a high index of suspicion for viral-induced complications in immunocompromised transplant recipients, as timely diagnosis and appropriate management are crucial for optimal patient outcomes. This case report contributes to the limited existing literature on Parvovirus B19-associated PRCA in the context of solid organ transplantation, emphasizing the need for heightened awareness and vigilance in post-transplant care.

Parvovirus in dermatology: A review

AbstractParvovirus B19 is a small nonenveloped single‐stranded DNA virus belonging to the parvoviridae family. The dermatological manifestations are varied ranging from infective to inflammatory, but the most common among infective etiologies is erythema infectiosum, also known as the fifth disease or ‘slapped cheek’ disease, which is mildly contagious. Clinical corroboration of symptoms and signs with serum antibody levels has been seen in acute and persistent parvoviral infections. Other dermatological manifestations of parvovirus B19 infections include erythema multiforme, vasculitis, reticular erythema, maculopapular eruptions, pustular eruptions, papular‐purpuric gloves and socks syndrome (PPGSS) and Gianotti‐Crosti syndrome. Skin lesions are quite characteristic and begin with oedema and erythema symmetrically localized to the hands and feet. Subsequently, petechial and purpuric changes appear varying from a few millimetres in diameter to larger, confluent patches. The primary target of parvovirus B19 is the hematopoietic‐erythroid cell line, specifically near the pronormoblast stage and the vulnerability to cellular damage increases along the differentiation lineage. There's multimodal clinical phenotypic presentation seen in parvoviral infections. Among the clinical expression of HPV B19 infections, the most common is dermatologic, however other manifestations such as rheumatologic and hematologic are not uncommon. However, some infections can be asymptomatic, especially in immunocompetent hosts, whereas in others with haematological abnormalities, these can lead to aplastic cellular crises.

Successful use of interferon alfa-2a for persistent parvovirus B19 infection.

Human infection with parvovirus B19 causes a range of clinical manifestations, including benign erythema infectiosum in children, arthralgias in adults, aplastic crisis in patients with bone marrow failure, and potentially fatal congenital hydrops fetalis. Persistent parvovirus B19 infection is a rare disease presentation mostly seen in adult women or immunocompromised individuals. Treatment options include corticosteroids and intravenous immunoglobulin; however, viral clearance is difficult to obtain and rarely maintained. In this Grand Round, we report the case of a 43-year-old man with persistent parvovirus B19 infection and anaemia, who was refractory to standard treatment regimens, and whom we successfully treated with pegylated interferon alfa-2a. Initial treatment led to viral clearance and remission of anaemia, although secondary recurrence of virus required treatment extension. Despite extensive genetic and immunological evaluations, no underlying primary or secondary immunodeficiency was identified in the patient. We propose interferon alfa-2a as a treatment option for persistent parvovirus B19 infection and advocate long-term follow-up of patients and potentially repeated treatment.

Parvo B19 and Anaemia: The Various Profiles – A Mini Review

Introduction: Parvovirus 19 (Parvo B19) is a single stranded DNA virus which predominantly affects school-aged children, parents of such children and adults who are working in day care centres or schools. Individuals with underlying haemoglobinopathies, haemophilia, immunocompromised, malignancy and pregnancy states are at a higher risk of infection. This virus has been associated with multiple clinical manifestations including erythema infectiosum, arthopathy, fetal cardiomyopathy and hydrops fetalis. However, one of the most significant complications is the anaemia caused in the adult population. This includes pure red cell aplasia and transient aplastic crisis (TAC). Review: Pure red cell aplasia occurs predominantly in patients with immunocompromised states. The aplasia characteristically presents with a chronic or recurrent severe normocytic normochromic anaemia with reticulocytopaenia. The bone marrow reveals an absence of red-cell precursors or with the presence of giant pro-normoblasts with intra-nuclear inclusions. The condition is effectively managed using packed red cell transfusions, based on the degree of anaemia, and with intravenous immunoglobulin at 1g/kg over a period of 2 days or, more preferably, 500mg/kg over 5 days. The majority of patients respond after 1-3 doses. Correction of the underlying patient risk factors is vital. TAC occurs more frequently in patients with underlying red-cell abnormalities. This presents with a one to two week severe anaemia with variable smear and cellular findings varying from microcytic hypochromic to normocytic normochromic. Additionally, there is a reduced reticulocyte percentage and index. Packed red cell transfusion and correction of the underlying risk factor are often sufficient for the management of anaemia. The addition of immunoglobulin administration, 500mg/kg over 5 days, may be needed for patients who are immunocompromised. Conclusion: Parvovirus B19 remains a prevalent and prominent virus associated with multiple medical conditions particularly in immunocompromised states such as that of HIV, as well as erythrocyte disorders. Clinically, the virus has a plethora of presentations, two of which are severe anaemias: transient aplastic crisis and pure red cell aplasia. These conditions may be effectively and successfully managed with intravenous packed red-cell transfusions, intravenous immunoglobulins and by addressing of the underlying patient risk factors.

Contribution of Parvovirus B19 in Suspected Cases of Measles/Rubella in Osaka, Japan, between 2011 and 2021.

Erythema infectiosum, caused by human parvovirus B19 (B19V), is difficult to diagnose by its clinical symptoms and is often misdiagnosed as measles or rubella. Timely confirmation of measles/rubella or other viral etiologies via laboratory tests can provide an accurate picture of the infection status, which can appropriate response. The purpose of this study was to determine the contribution of B19V as an etiological agent for fever-rash in suspected cases of measles and rubella in Osaka Prefecture between 2011 and 2021. Of 1356 suspected cases, 167 were confirmed with measles and 166 with rubella using nucleic acid testing (NAT). Of the remaining 1023 cases, 970 from which blood specimens could be obtained were screened by real-time PCR for B19V, from which 136 (14%) tested positive. Of the positives cases, 21% were young children (9 years and younger), while 64% were adults (20 years and older). Phylogenetic tree analysis showed that 93 samples belonged to genotype 1a. The importance of B19V in the etiology of fever-rash illness was revealed in this study. The importance of laboratory diagnosis by NAT in maintaining the status of measles elimination and to eliminate rubella was reaffirmed. This article is protected by copyright. All rights reserved.

Parvovirus B19 infection in a patient of juvenile arthritis: A case report

Abstract Parvovirus B19 infection, or fifth disease or erythema infectiosum, is a self-limiting viral exanthem and can occur along with other connective tissue disorders. Occasionally, children may have preceding chronic joint complaints suggestive of juvenile idiopathic arthritis. A 7-year-old female patient presented to the outpatient department with a rash over her face, upper and lower limbs, and trunk, which was preceded by fever. The patient is a known case of juvenile arthritis. On examination, there were multiple erythematous and skin-colored plaques over cheeks; few pustules over lips; multiple erythematous papules over upper limbs, lower limbs, and trunk; multiple erythematous macules over palms; and swelling over interphalangeal joints of bilateral hands, elbow and knee joints with genu valgum deformity of limbs. The patient was given topical antibiotic and steroid combination cream and oral antihistaminic for her cutaneous complaints.

Treating Parvovirus Triggered Refractory Hemolytic Anemia with Rituximab in Renal Transplant Recipients - A Report of Two Cases.

Parvovirus B19 is a small (26 nm), nonenveloped, single-stranded DNA (5.6-kb) virus. The only known host for parvovirus B19 is humans. Parvovirus B19 is directly cytotoxic to erythroid precursor cells of the colony- and burst-forming units. Human parvovirus B19 is the etiologic agent of erythema infectiosum and chronic pure red cell aplasia in immunocompromised individuals. Acute parvovirus B19 infection should be suspected in immunocompromised patients, who present with reticulocytopenic hemolytic anemia and thrombocytopenia. Intravenous immunoglobulin (IVIg) is the standard treatment for parvovirus-induced cytopenias. We report two cases of postrenal transplant who presented with reticulocytopenic anemia and were found to have parvovirus infection. They did not respond to conventional treatment with intravenous gamma globulin. Both patients were treated with rituximab with which they had improvement in clinical and hematological parameters. There was no previous documentation of using rituximab in the treatment of parvovirus-triggered autoimmune hemolytic anemia postrenal transplant patients. This article illustrates how rituximab will be helpful in this setting, of course, it is a new thought but requires further studies and validation.

Molecular detection of human parvovirus B19 DNA amongst pregnant women attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria

Background: Parvovirus B19 infection causes a wide range of complication in pregnant women including spontaneous abortion, severe fetal anaemia, non-immune hydrops fetalis and even intrauterine fetal death, erythema infectiosum (5th) disease and aplastic crisis. Objective: To perform molecular detection of human Parvovirus B19 among pregnant women attending antenatal clinic in Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria. Materials and Methods: This is a cross-sectional study conducted among 92 consented pregnant women, between the ages of 20-40 years who are attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital Anambra State, Nigeria, from May 2020-November 2020. A total of 92 blood specimen was collected from the pregnant women. Result: Out of the 20 IgM positive samples analyzed for Parvovirus B19 DNA, 13(65.0%) had Parvovirus B19 DNA and 7(35.0%) were negative for Parvovirus B19 DNA. Prevalence of Parvovirus B19 DNA in relation to gestational age was highest (69.2%) among pregnant women who were in their 2nd trimester and the prevalence was lowest (0.0%) among pregnant women who were in their 3rd trimester. Prevalence of Parvovirus B19 in relation to history of blood transfusion was highest (100.0%) among pregnant women who have had transfusion history and the prevalence was lowest (0.0%) among pregnant women who had no transfusion history. Conclusion: The frequency rate of Parvovirus B19 DNA seropostivity was highest (65.0%) among the pregnant women investigated. The association of Parvovirus B19 DNA seroposivity with gestation age and history of blood transfusion was statistically significant.

Parvovirus B19 status in liver, kidney and pancreas transplant candidates: A single center experience.

Parvovirus B19 (B19V) is associated with a wide range of clinical manifestations. The major presentation is erythema infectiosum. However, a persistent infection may cause pure red cell aplasia and chronic anemia in immunocompromized patients. The B19V seroprevalence varies with age and geographical location. To determine the B19V serological status and DNAemia in kidney, liver, and pancreas transplant candidates. Patients who underwent kidney, liver, or simultaneous kidney and pancreas/liver transplantation between January 2021 and May 2022 were included in the study. The serum samples were collected before transplantation. For detection of B19V DNA, a LightMix Kit B19V EC (TIB MOLBIOL, Berlin, Germany) was used. B19V IgM and IgG antibodies were detected using a commercial ELISA test (Euroimmun, Lübeck, Germany). One hundred and thirty-one transplant candidates were included in the study, 71.0% male, with an average age of 53.27 years ± 12.71 years. There were 68.7% liver, 27.5% kidney, 3.0% simul taneous pancreas/kidney transplant (SPKT), and 0.8% simultaneous liver/kidney transplant recipients. No patients had detectable B19V DNA. B19V IgG seroprevalence was 77.1%. No acute or recent infections were detected (IgM antibodies). There was no difference in the mean age of seronegative and seropositive patients (51.8 years ± 12.9 years vs 53.7 years ± 12.7 years, t = -0.603; P = 0.548). Although seropositivity was lower in patients aged less than 30 years (66.6%) compared to the patients aged 30-59 years and > 60 years (80.4% and 78.1%, respectively), this difference was not significant. In addition, there was no difference in seropositivity between male and female transplant candidates, 76.3% and 78.9% (χ 2 = 0.104; P = 0.748). The seroprevalence did not differ among organ recipients, with 77.8%, 80.6%, and 50.0% for liver, kidney, and SPKT, respectively, (χ 2 = 5.297; P = 0.151). No significant difference was found in the seroprevalence in kidney transplant patients according to dialysis modality. Seroprevalence was 71.1% in hemodialysis patients, and 100% in peritoneal dialysis patients (χ 2 = 0.799; P = 0.372). The B19V seroprevalence is expectedly high among kidney, liver, and pancreas transplant candidates, but there are still 22.9% of seronegative individuals who remain at risk for primary disease and severe manifestations. Further research should elucidate the necessity of B19V screening in peri-transplant management.

Parvovirus-induced autoimmune hepatitis: First case in the literature

Parvovirus B19 infection is usually self-limiting in immunocompetent individuals. Twenty-five percent of infected individuals are
 completely asymptomatic during infection, with 50% of them presenting flu-like symptoms and the remaining patients presenting
 erythema infectiosum, arthralgia, or arthritis. More rarely, transient aplastic crisis is seen in individuals with chronic haemolytic
 disorders. Chronic pure red cell aplasia and aplastic anaemia may also be observed in immunocompromised patients. There is
 sufficient evidence in the literature suggesting that B19 infections can also cause a spectrum of liver diseases, ranging from elevated
 transaminase levels to acute hepatitis, fulminant liver failure, and even chronic hepatitis. This case report discusses a patient with
 acute parvovirus infection and newly diagnosed autoimmune hepatitis (AIH) and the role of this viral infection in the disease.

Parvovirus В19 infection: lecture

Parvovirus B19 infection is best known as erythema infectiosum. However, infection with parvovirus B19 can lead to damage to various organs and systems, the development of severe complications up to death. The infection is most dangerous for people with immunodeficiency and hematological diseases. Serious consequences are possible with intrauterine infection of the fetus. Knowledge about the characteristics of the pathogen, the pathogenesis of the disease, the variety of clinical manifestations will allow the doctor to avoid diagnostic errors and provide the patient with timely medical care.