Two family members with a syndrome of headache and rash caused by human parvovirus B19

Human parvovirus B19 infection can cause erythema infectiosum (EI) and several other clinical presentations. Central nervous system (CNS) involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 years old female with a 7-day history of headache, malaise, myalgias, joint pains, and rash was seen. Physical examination revealed a maculopapular rash on the patient's body, and arthritis of the hands. She completely recovered in 1 week. Two days before, her 6 year old son had been admitted to a clinic with a 1-day history of fever, headache, abdominal pain and vomiting. On admission, he was alert, and physical examination revealed neck stiffness, Kerning and Brudzinski signs, and a petechial rash on his trunk and extremities. Cerebrospinal fluid analysis was normal. He completely recovered in 5 days. Acute and convalescent sera of both patients were positive for specific IgM antibody to B19. Human parvovirus B19 should be considered in the differential diagnosis of aseptic meningitis, particularly during outbreaks of erythema infectiosum. The disease may mimic meningococcemia and bacterial meningitis.

Human parvovirus B19 infection: clinical and epidemiological study of 24 cases

No periodo de maio/94 a novembro/95, 24 casos de parvovirose humana foram atendidos no Servico de Doencas Infecciosas e Parasitarias do Hospital Universitario Antonio Pedro, Niteroi - RJ. Amostras sanguineas para a deteccao de IgM (ensaio imunoenzimatico por captura) foram positivas do primeiro ao vigesimo setimo dia apos o inicio do exantema. Os sinais e sintomas classicos do eritema infeccioso foram observados em 8 (33,3 por cento) dos casos e apenas em criancas. Oito pacientes (6 adultos e 2 criancas) apresentaram poliartropatia simetrica, vista mais frequentemente em mulheres. Os resultados deste trabalho demonstram que o diagnostico da parvovirose humana e dificil quando a doenca nao apresenta quadro clinico classico e, devido ao frequente envolvimento das articulacoes, tal infeccao deve ser considerada no diagnostico diferencial da artrite reumatoide na sua fase inicial