Casi contributivi
Le diverse “facce” del parvovirus B19
The different “faces” or parvovirus b19
Bloise S, Iacono A, Bruno I, Buffon S, Lasala V, Cocchi E, Marchetti F.
Aprile 2025 - pagg. 257 -258 | DOI: 10.53126/MEB44257
Abstract
Parvovirus B19 (B19V) is classically known as the etiologic agent of Fifth disease, typically characterised by mild symptoms (as fever, myalgias and headache), confluent erythema on the cheeks (“slapped cheeks”) and subsequent symmetrical reticulated rash on the body. However, in some cases, the B19V rash may have different features and the infection may be associated with potentially serious complications. The paper presents a case of a 5-year-old child with an atypical skin manifestation of B19V (pustular rash) and a severe course of infection with cardiac involvement. Although, in most cases the typical skin expression of B19V is Fifth disease, the rash may also occur in other forms, such as morbilliform, confluent, vesicular or pustular. Furthermore, the infection, usually benign and self-limiting, may be associated with severe manifestations involving multiple organ systems (cardiac, neurological, hepatic, and renal)s with need of different treatment strategies (symptomatic, immunoglobulin, corticosteroid, or other forms of care). Early recognition and timely intervention are critical to improving the outcome of patients with B19V-related complications.
Riassunto
Il parvovirus B19 (B19V) č classicamente noto come l’agente eziologico della quinta malattia, tipicamente caratterizzata da sintomi lievi (come febbre, mialgie e mal di testa), eritema confluente sulle guance (“guance schiaffeggiate”) e conseguente eruzione reticolata simmetrica sul corpo. Tuttavia, in alcuni casi, l’eruzione cutanea da B19V puň avere caratteristiche diverse e l’infezione puň essere associata a complicazioni potenzialmente gravi. Presentiamo il caso di una bambina di 5 anni con una manifestazione cutanea atipica di B19V (rash pustoloso) e un decorso grave di infezione con coinvolgimento cardiaco. Sebbene nella maggior parte dei casi l’espressione cutanea tipica del B19V sia la quinta malattia, l’esantema puň manifestarsi anche in altre forme: morbilliforme, confluente, vescicolare o pustolosa. Inoltre l’infezione, solitamente benigna e autolimitante, puň essere associata a manifestazioni gravi e coinvolgere piů organi e/o apparati (cardiaco, neurologico, epatico e renale) con necessitŕ di diverse strategie di trattamento (sintomatico, immunoglobuline, corticosteroidi o altre forme di cura). Il riconoscimento e l’intervento tempestivo sono fondamentali per migliorare l’esito dei pazienti con complicanze legate a B19V.
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Classificazione MeSH
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Bibliografia
1. Patalon T, Saciuk Y, Trotzky D, et al. An Outbreak of Parvovirus B19 in Israel. Viruses. 2023;15(11):2261. doi: 10.3390/v15112261.
2. d’Humičres C, Fouillet A, Verdurme L, et al. An unusual outbreak of parvovirus B19 infections, France, 2023 to 2024. Euro Surveill 2024;29(25):2400339. doi: 10.2807/1560-7917.ES.2024.29. 25.2400339.
3. Bloise S, Cocchi E, Mambelli L, Radice C, Marchetti F. Parvovirus B19 infection in children: a comprehensive review of clinical manifestations and management. Ital J Pediatr 2024;50(1):261. doi: 10.1186/s13052-024-01831-6.
4. Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Erythema Infectiosum: A Narrative Review. Curr Pediatr Rev 2024;20(4):462-71. doi: 10.2174/1573396320666230428104619.
5. Boeck K, Mempel M, Schmidt T, Abeck D. Gianotti-Crosti syndrome: clinical, serologic, and therapeutic data from nine children. Cutis 1998;62(6):271-4; quiz 286.
6. Grilli R, Izquierdo MJ, Farińa MC, et al. Papular-purpuric "gloves and socks" syndrome: polymerase chain reaction demonstration of parvovirus B19 DNA in cutaneous lesions and sera. J Am Acad Dermatol 1999;41(5 Pt 1):793-6. doi: 10.1016/s0190-9622(99)70027-7.
7. Douvoyiannis M, Litman N, Goldman DL. Neurologic manifestations associated with parvovirus B19 infection. Clin Infect Dis 2009;48(12):1713-23. doi: 10.1086/599042.
8. Chaabouni L, Amira C, Abdelmoula L, Ben Had YC, Kchir MM, Zouari R. Manifestations rhumatologiques de l’infection a parvovirus B19 [Rheumatologic manifestations of parvovirus B19 infection]. Tunis Med 2004;82(7):642-7. French.
9. Díaz F, Collazos J. Hepatic dysfunction due to parvovirus B19 infection. J Infect Chemother 2000;6(1):63-4. doi: 10.1007/ s101560050052.
10. Pabisiak K, Stępniewska J, Ciechanowski K. Pure Red Cell Aplasia After Kidney Transplantation: Parvovirus B19 Culprit or Coincidence? Ann Transplant 2019;24:123-31. doi: 10.12659/AOT.913663.
11. Verdonschot J, Hazebroek M, Merken J, et al. Relevance of cardiac parvovirus B19 in myocarditis and dilated cardiomyopathy: review of the literature. Eur J Heart Fail 2016;18(12):1430-41. doi: 10.1002/ejhf.665.
12. Keramari S, Poutoglidis A, Chatzis S, Keramaris M, Savopoulos C, Kaiafa G. Parvovirus B19-Associated Myocarditis: A Literature Review of Pediatric Cases. Cureus 2022;14(1):e21726. doi: 10.7759/cureus.21726.
13. Ammirati E, Frigerio M, Adler ED, et al. Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy: An Expert Consensus Document. Circ Heart Fail 2020;13(11):e007405. doi: 10.1161/CIRCHEARTFAILURE.120.007405.
14. Esmel-Vilomara R, Dolader P, Izquierdo-Blasco J, et al. Parvovirus B19 myocarditis in children: a diagnostic and therapeutic approach. Eur J Pediatr 2022;181(5):2045-53. doi: 10.1007/s00431-022-04406-x.
Corrispondenza: silvia.bloise@auslromagna.it