Case history
Case history
A 6-year-old child presents to the clinic in February with bright red macules on his cheeks and a lacy, reticular eruption on his extremities and torso. His mother reports that last week he did have symptoms of a mild cold. Other than the exanthem, the child appears healthy.
Other presentations
In adults with parvovirus B19, self-limited symmetric polyarthropathy of the small joints is often the most common presenting complaint and may or may not be accompanied by the typical exanthem. In addition to erythema infectiosum, another exanthem caused by parvovirus B19 is that of papular purpuric gloves and socks syndrome (PPGSS). This eruption is classically characterised by painful oedema, pruritus, and sharply marginated petechiae and purpura of the hands and feet. PPGSS may be associated with fever, mucocutaneous lesions or morphologically similar lesions outside the typical distribution.[1] Unlike erythema infectiosum, this eruption is associated with concurrent viraemia and infectivity. Patients who are immunocompromised (e.g., patients with HIV, people receiving chemotherapy or immunosuppression following transplant, or patients with congenital immunodeficiencies) may not present with classic erythema infectiosum, but may develop chronic anaemia/pure red cell aplasia due to persistent parvovirus B19 infection.[2] Complications including transient aplastic crisis may occur in people with increased red blood cell turnover/destruction (e.g., hereditary spherocytosis, sickle cell disease, thalassaemia, iron deficiency anaemia) and infection in pregnant women may result in severe fetal anaemia and hydrops fetalis. Rare reports of nephritis, hepatitis, and neurological disease in association with parvovirus B 19 infection have been reported.[3][4][5][6] In addition, parvovirus has been attributed to cardiomyopathy in children.[7]
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