Parvovirus B19 infection

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Abstract

Back to topParvovirus B19 infection: SummaryParvovirus B19 infection may cause slapped cheek syndrome (erythema infectiosum or fifth disease), commonly in school-age children. It is usually a mild, self-limiting illness.Complications of parvovirus B19 infection are rare in healthy people. Pregnant women, and people who are immunocompromised or have haematological disorders, are at increased risk of serious complications, such as: Hydrops fetalis or fetal death (in pregnancy).Transient aplastic anaemia, pure red cell aplasia, or persistent anaemia.In healthy children, the diagnosis of parvovirus B19 infection is usually clinical. Children may present with an acute biphasic illness with a characteristic diffuse erythematous facial rash, appearing on one or both cheeks.The rash may be preceded by prodromal symptoms, and an erythematous maculopapular rash on the trunk, back, and limbs may develop.In healthy adults, it may be difficult to make a clinical diagnosis, as symptoms may be atypical or absent. Prodromal symptoms may appear about a week after any known contact.The facial rash seen in children is rare, but a maculopapular rash on the trunk, back, and limbs may develop.A symmetrical polyarthropathy may subsequently develop.In healthy children and adults, laboratory investigation to confirm the diagnosis is not required.If a pregnant woman has suspected parvovirus B19 infection or possible exposure to infection, the local virology, microbiology, or infectious diseases department should be contacted immediately for further advice on laboratory investigations to arrange.If parvovirus B19 infection is suspected in a person who is immunocompromised, has a haematological disorder, or is in early transient aplastic crisis, urgent blood tests should be arranged for: High-titre viral DNA to confirm the diagnosis, and full blood count (including reticulocyte count).For children and adults (who are not pregnant) with suspected parvovirus B19 infection, management includes advice on: Symptom relief, such as fluids, analgesia, and rest.The need for exclusion from school, nursery, or work (if appropriate). Note: this is not usually necessary as the person is no longer infectious one day after any rash or symptoms develop.Avoiding contact with people at increased risk of complications (if appropriate).For children and adults (who are not pregnant) who have had possible exposure to parvovirus B19 infection, management includes advice on: Avoiding contact with people at increased risk of complications (if appropriate).For pregnant women, if parvovirus B19 infection is suspected or there has been possible exposure to infection, at any stage of pregnancy: The local virology, microbiology, or infectious diseases department should be contacted immediately for further advice on laboratory investigations and monitoring to arrange.The woman should be advised on avoiding contact with other pregnant women and people at risk of complications, until she is known to be uninfected, immune to infection, or no longer potentially infectious.If parvovirus B19 infection is confirmed, an urgent referral to a specialist in fetal medicine should be arranged, for ongoing fetal monitoring and management.

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