From the Guidelines
Parvovirus B19 is the causative agent of erythema infectiosum, also known as fifth disease, a common and typically mild childhood illness characterized by a distinctive "slapped cheek" rash. This condition is usually self-limiting in healthy individuals, but it can have more severe consequences in high-risk individuals, such as pregnant women, immunocompromised patients, and those with chronic anemia 1.
Key Characteristics of the Disease
- The virus spreads through respiratory droplets and blood, and can cause temporary aplastic crisis in patients with underlying hemolytic disorders.
- Pregnant women exposed to the virus should be monitored due to the risk of fetal hydrops, which can be life-threatening for the fetus.
- Prevention involves good hygiene practices, especially handwashing, as there is no vaccine available.
- Once infected, individuals develop lifelong immunity.
Treatment and Management
Treatment for erythema infectiosum is generally supportive, focusing on relieving symptoms:
- Rest and adequate hydration
- Acetaminophen or ibuprofen for fever and discomfort (following age-appropriate dosing)
- No specific antiviral treatment is required for most cases For high-risk individuals:
- Close monitoring is essential
- Intravenous immunoglobulin (IVIG) may be considered in severe cases, with a dose of 400 mg/kg/day for 5 days, although the specific management may vary depending on the individual's condition and the severity of the infection 1.
Complications and Special Considerations
Parvovirus B19 infection can lead to significant complications in certain populations, including the development of nonimmune hydrops fetalis (NIHF) in fetuses, which is associated with high mortality rates 1. Fetal intrauterine transfusion is recommended for NIHF due to parvovirus infection, unless the pregnancy is at an advanced gestational age and the risks associated with delivery are considered less than those associated with the procedure. The risk of poor outcomes for the fetus is greatest when the congenital infection occurs in the early second trimester, highlighting the importance of early detection and management 1.
From the Research
Relationship between Parvovirus B19 and Erythema Infectiosum
- Parvovirus B19 is the causative agent of erythema infectiosum, also known as Fifth disease 2, 3, 4, 5, 6
- Erythema infectiosum is a common exanthematous illness of childhood, characterized by a "slapped-cheek" appearance on the face and a lacy exanthem on the trunk and extremities 4
- The virus spreads mainly through respiratory droplets and can cause a range of symptoms, including mild, nonspecific, cold-like symptoms, as well as more severe conditions such as acute or persistent arthropathy and papular, purpuric eruptions on the hands and feet 2, 5, 6
- The diagnosis of erythema infectiosum is mainly clinical, but laboratory confirmation can be made through serum immunoglobulin M testing or viral DNA testing in certain cases 2, 3
Clinical Manifestations and Complications
- Erythema infectiosum can cause a range of clinical manifestations, including arthritis, arthralgia, and transient aplastic crisis 4, 5
- In adults, the rash is less pronounced than in children and is often atypical, but a reticulated or lacy erythema can be noted in 80% of cases 4
- Complications of parvovirus B19 infection can include hydrops fetalis in pregnant women, as well as autoimmune diseases such as autoimmune neutropenia, thrombocytopenia, and hemolytic anemia 5
- Treatment of erythema infectiosum is usually symptomatic and supportive, but may require transfusions or intravenous immune globulin therapy in certain cases 2, 3