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Non-immune hydrops fetalis represents a diagnostic challenge in high-risk pregnant women. Vertical infection with human parvovirus B19 (B19V) is a possible cause. National guidelines propose maternal serologic screening (IgG/IgM), which may be insufficient in some situations. We report a case of vertical B19V infection with difficulties in prenatal diagnosis. Preterm newborn, normal weight (2950 g), born to a 30-year-old mother with anemia and hydrops fetalis (week 17). Cardiac, chromosomal, isoimmunization-Rh, and usual infectious causes (TORCH) were ruled out. Maternal serology for B19V showed IgG+ and IgM-, and the diagnosis was dismissed. The newborn presented abdominal distension (ascites), anemia, and jaundice. Postnatal results confirmed the diagnosis with DNA+ for B19V. Discharge at 17 days with good evolution. The protocol for B19V screening in vertical infection needs to be revised by incorporating early molecular studies (PCR) from the early stages of gestation to optimize the diagnosis and treatment of patients with this congenital infection.
La hidropesía fetal no inmune representa un desafío diagnóstico en embarazadas de alto riesgo. La infección vertical por parvovirus humano B19 (B19V) es una causa posible. Las guías nacionales proponen pesquisas serológicas maternas (IgG/IgM) que pueden ser insuficientes en algunas situaciones. Se reporta un caso de infección vertical por B19V con dificultades en el diagnóstico prenatal. Recién nacido prematuro, peso adecuado (2950 g). Hijo de madre de 30 años, con anemia e hidropesía fetal (semana 17). Se descartaron causas cardíacas, cromosómicas, isoinmunización-Rh e infecciosas habituales (TORCH). Serología materna para B19V mostró IgG+ e IgM- desestimando el diagnóstico. El neonato presentó distensión abdominal (ascitis), anemia e ictericia. Resultados posnatales confirmaron diagnóstico con ADN+ para B19V. Alta a los 17 días con buena evolución. El protocolo de pesquisa de B19V en infección vertical requiere ser revisado incorporando precozmente estudios moleculares (PCR) desde etapas tempranas de la gestación, y así optimizar el diagnóstico y tratamiento de los pacientes con esta infección congénita.
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Introduction: Human Erythrovirus (parvovirus) B19 infection can produce symptoms similar to those produced by Dengue, Chikungunya, and Zika viruses, making clinical diagnosis difficult. The importance of erythrovirus B19 in human pathology has been increased and reported in numerous studies published globally. Methods: The B19V infection was investigated by real-time PCR in sera samples from patients with signs and symptoms related to classic arboviral symptoms. This study was conducted to provide information on the genetic diversity of Human Erythrovirus B19 (B19V) circulating in the state of Mato Grosso do Sul, Midwest region of Brazil, from 2017 to 2022. A total of 773 sera samples of patients with negative diagnostic results for Dengue, Chikungunya, and Zika, during the study period were analyzed. Results: Erythrovirus DNA was found in 10.6% (82/773) of patients, among them 10 were pregnant women. Four samples were completely sequenced, and the other five partially, to genotype by phylogenetic reconstruction. All samples belong to worldwide dispersed genotype 1, subgenotype 1a. Discussion: The findings of the study demonstrate the importance of including B19V in differential laboratory diagnosis for epidemiological purposes and appropriate patient management. The diagnosis for B19V should be performed, particularly among pregnant women, immunocompromised patients, and individuals with hemolytic diseases, given that the infection is more severe in these cases.
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Parvoviruses are responsible for multiple diseases, and there is a critical need for effective antiviral therapies. Specific antiviral treatments for parvovirus infections are currently lacking, and the available options are mostly supportive and symptomatic. In recent years, significant research efforts have been directed toward understanding the molecular mechanisms of parvovirus replication and identifying potential targets for antiviral interventions. This review highlights the structure, pathogenesis, and treatment options for major viruses of the subfamily Parvovirinae, such as parvovirus B19 (B19V), canine parvovirus type 2 (CPV-2), and porcine parvovirus (PPV) and also describes different approaches in the development of antiviral alternatives against parvovirus, including drug repurposing, serendipity, and computational tools (molecular docking and artificial intelligence) in drug discovery. These advances greatly increase the likelihood of discoveries that will lead to potent antiviral strategies against different parvovirus infections.
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Infecciones por Parvoviridae , Parvovirinae , Parvovirus B19 Humano , Parvovirus , Animales , Porcinos , Antivirales/farmacología , Antivirales/uso terapéutico , Inteligencia Artificial , Simulación del Acoplamiento Molecular , Infecciones por Parvoviridae/tratamiento farmacológicoRESUMEN
Parvovirus B19, a member of the Parvoviridae family, is a human pathogenic virus. It can be transmitted by respiratory secretions, hand-to-mouth contact, blood transfusion, or transplacental transmission. Most patients are asymptomatic or present with mild symptoms such as erythema infectiosum, especially in children. In rare cases, moderate-to-severe symptoms may occur, affecting blood cells and other systems, resulting in anemia, thrombocytopenia, and neutropenia. Non-immune pregnant women are at risk for fetal infection by parvovirus B19, with greater complications if transmission occurs in the first or second trimester. Infected fetuses may not show any abnormalities in most cases, but in more severe cases, there may be severe fetal anemia, hydrops, and even pregnancy loss. Maternal diagnosis of intrauterine parvovirus B19 infection includes IgG and IgM antibody testing. For fetal diagnosis, PCR is performed through amniocentesis. In addition to diagnosing the infection, it is important to monitor the peak of systolic velocity of the middle cerebral artery (PVS-MCA) Doppler to assess the presence of fetal anemia. There is no vaccine for parvovirus B19, and fetal management focuses on detecting moderate/severe anemia by fetal PVS-MCA Doppler, which, if diagnosed, should be treated with intrauterine transfusion by cordocentesis. Prevention focuses on reducing exposure in high-risk populations, particularly pregnant women.
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Collapsing glomerulopathy (CG) is a rare glomerular disease and its familial form is even rarer. CG and non-collapsing forms of focal segmental glomerulosclerosis may both be caused by pathogenic variants in the same genes, but there is less information on genetics of the former disease. We hypothesized that different hits (viral infection and genetic variants) may be involved in the development of a familial CG here described. We performed renal and etiological routine evaluation, PVB19 serology, genetic tests including whole-exome analysis and dosage of serum thrombomodulin (THBD) in two siblings with CG, one healthy sister, and their mother. The THBD gene variant p.A43T in homozygosity was identified in the proband and her affected brother, both with CG. The same mutation was identified in their mother in heterozygosity. THBD levels were elevated in the serum of both affected siblings. They also had PVB19 positive serology and the G1 high-risk apolipoprotein L1 (APOL1) alleles in homozygosity. Their healthy sister had no PVB19-positive serology and no THBD nor APOL1 gene variants. In this case of familial CG, THBD, and APOL1 gene variants, and a previous PVB19 infection may be associated with the development of CG in a multihit process. In addition, the p.A43T THBD variant, identified in the affected siblings, has never been previously described in homozygosis, pointing to a likely autosomal recessive CG trait caused by this gene mutation.
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Predisposición Genética a la Enfermedad , Mutación , Trombomodulina , Humanos , Trombomodulina/genética , Femenino , Masculino , Glomeruloesclerosis Focal y Segmentaria/genética , Linaje , Apolipoproteína L1/genética , AdultoRESUMEN
Virus-like particles (VLPs) are nanometric structures composed of structural components of virions, keeping most of the cellular recognition and internalization properties, but are non-infective as they are deprived of their genetic material. VLPs have been a versatile platform for developing vaccines by carrying their own or heterologous antigenic epitopes. Moreover, VLPs can also be used as nanovessels for encapsulating molecules with therapeutic applications, like enzymes, nucleic acids, and drugs. Parvovirus B19 (B19V) VLPs can be self-assembled in vitro from the denatured major viral particle protein VP2 by equilibrium dialysis. Despite its fair productivity, this process is currently a time-consuming task. Affinity chromatography is used as an efficient step for concentration and purification, but it is only sometimes seen as a method that facilitates the oligomerization of proteins. In this research, we report a novel approach for the in vitro assembly of B19V VLPs through the immobilization of the denatured VP2 into an immobilized metal affinity chromatography (IMAC) column, followed by the on-column folding and the final VLP assembly upon protein elution. This method is suitable for the fast production of B19V VLPs. KEY POINTS: ⢠Biotechnological applications for inclusion bodies ⢠Efficient single-step purification and immobilization strategies ⢠Rapid VLP assembly strategy.
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Proteínas Bacterianas , Parvovirus B19 Humano , Parvovirus B19 Humano/genética , Bacterias , Biotecnología , Cromatografía de AfinidadRESUMEN
Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymptomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are common to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl admitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admission and discontinued after negative laboratory results were obtained. Nine days after symptoms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations and emphasizes that its possible involvement might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.
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Osteoarthritis and Parvovirus B19 infection present silent and gradual evolution, since the former is a degenerative process while the latter is often asymptomatic and may persist in the individual's body during their life. This study aims to analyze clinical studies that establish a correlation between degenerative osteoarthritis and Parvovirus B19 infection. Of the 62 studies found, 25 were chosen for reading in full. Analyzing only the studies that establish the correlation between the pathologies, seven confirm this relationship between Parvovirus B19 and Osteoarthritis, while one reports no relationship. No objective correlation could be found between the other articles studied. Our findings suggest that there is a close relationship between Parvovirus B19 and Osteoarthritis, with a higher prevalence of acquired causes, women and older adults, but it can manifest during life. However, it is essential to carry out new studies involving family history of patients with Osteoarthritis with positivity of Parvovirus B19, cohort studies between childhood and adult-old adult, so that it can elucidate this duality of congenital-acquired cause and, finally, raise treatment alternatives. Level of Evidence II, Systematic Review of Level II Studies.
Tanto a osteoartrite quanto a infecção pelo parvovírus B19 apresentam evolução muitas vezes silenciosa e gradual, uma vez que a primeira é um processo degenerativo, e a segunda é geralmente assintomática, podendo persistir no corpo do indivíduo por toda a sua vida. Esta revisão bibliográfica visa analisar estudos clínicos que estabeleceram a correlação entre a osteoartrite degenerativa e a infecção pelo parvovírus B19. Dos 62 artigos encontrados, foram eleitos 25 para leitura em sua totalidade. Analisando apenas os artigos que estabelecem a relação entre as patologias, temos sete que confirmaram essa relação, enquanto um deles afirmou que não há relação. Não houve correlação objetiva entre os demais artigos estudados. Nossos resultados sugerem que há estreita relação entre a osteoartrite e o parvovírus B19, que tende a ser uma doença de causa adquirida com maior prevalência em mulheres e idosos, porém que pode se manifestar durante toda a vida. Contudo, é crucial a realização de novos estudos envolvendo antecedentes familiares de pacientes com osteoartrite e com positividade para o parvovírus B19 e estudos de coorte entre a infância e o adulto-idoso, a fim de elucidar essa dualidade de causa congênita-adquirida e, enfim, levantar alternativas de tratamento. Nível de Evidência II, Revisão Sistemática de Estudos de Nível II.
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Parvovirus B19 (B19V) infection varies clinically depending on the host's immune status. Due to red blood cell precursors tropism, B19V can cause chronic anemia and transient aplastic crisis in patients with immunosuppression or chronic hemolysis. We report three rare cases of Brazilian adults living with human immunodeficiency virus (HIV) with B19V infection. All cases presented severe anemia and required red blood cell transfusions. The first patient had low CD4+ counts and was treated with intravenous immunoglobulin (IVIG). As he remained poorly adherent to antiretroviral therapy (ART), B19V detection persisted. The second patient had sudden pancytopenia despite being on ART with an undetectable HIV viral load. He had historically low CD4+ counts, fully responded to IVIG, and had undiagnosed hereditary spherocytosis. The third individual was recently diagnosed with HIV and tuberculosis (TB). One month after ART initiation, he was hospitalized with anemia aggravation and cholestatic hepatitis. An analysis of his serum revealed B19V DNA and anti-B19V IgG, corroborating bone marrow findings and a persistent B19V infection. The symptoms resolved and B19V became undetectable. In all cases, real time PCR was essential for diagnosing B19V. Our findings showed that adherence to ART was crucial to B19V clearance in HIV-patients and highlighted the importance of the early recognition of B19V disease in unexplained cytopenias.
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Síndrome de Inmunodeficiencia Adquirida , Anemia , Eritema Infeccioso , Infecciones por VIH , Infecciones por Parvoviridae , Parvovirus B19 Humano , Masculino , Humanos , Adulto , VIH/genética , Inmunoglobulinas Intravenosas , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Anemia/diagnóstico , Anemia/etiología , Parvovirus B19 Humano/genética , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , ADN Viral/análisisRESUMEN
ABSTRACT Osteoarthritis and Parvovirus B19 infection present silent and gradual evolution, since the former is a degenerative process while the latter is often asymptomatic and may persist in the individual's body during their life. This study aims to analyze clinical studies that establish a correlation between degenerative osteoarthritis and Parvovirus B19 infection. Of the 62 studies found, 25 were chosen for reading in full. Analyzing only the studies that establish the correlation between the pathologies, seven confirm this relationship between Parvovirus B19 and Osteoarthritis, while one reports no relationship. No objective correlation could be found between the other articles studied. Our findings suggest that there is a close relationship between Parvovirus B19 and Osteoarthritis, with a higher prevalence of acquired causes, women and older adults, but it can manifest during life. However, it is essential to carry out new studies involving family history of patients with Osteoarthritis with positivity of Parvovirus B19, cohort studies between childhood and adult-old adult, so that it can elucidate this duality of congenital-acquired cause and, finally, raise treatment alternatives. Level of Evidence II, Systematic Review of Level II Studies.
RESUMO Tanto a osteoartrite quanto a infecção pelo parvovírus B19 apresentam evolução muitas vezes silenciosa e gradual, uma vez que a primeira é um processo degenerativo, e a segunda é geralmente assintomática, podendo persistir no corpo do indivíduo por toda a sua vida. Esta revisão bibliográfica visa analisar estudos clínicos que estabeleceram a correlação entre a osteoartrite degenerativa e a infecção pelo parvovírus B19. Dos 62 artigos encontrados, foram eleitos 25 para leitura em sua totalidade. Analisando apenas os artigos que estabelecem a relação entre as patologias, temos sete que confirmaram essa relação, enquanto um deles afirmou que não há relação. Não houve correlação objetiva entre os demais artigos estudados. Nossos resultados sugerem que há estreita relação entre a osteoartrite e o parvovírus B19, que tende a ser uma doença de causa adquirida com maior prevalência em mulheres e idosos, porém que pode se manifestar durante toda a vida. Contudo, é crucial a realização de novos estudos envolvendo antecedentes familiares de pacientes com osteoartrite e com positividade para o parvovírus B19 e estudos de coorte entre a infância e o adulto-idoso, a fim de elucidar essa dualidade de causa congênita-adquirida e, enfim, levantar alternativas de tratamento. Nível de Evidência II, Revisão Sistemática de Estudos de Nível II.
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Mato Grosso (MT) State is part of central western Brazil and has a tropical permissive environment that favors arbovirus outbreaks. A metagenomic approach was used to identify viral genomes in seven pools of serum from patients (n=65) with acute febrile disease. Seven chikungunya virus (CHIKV) genomes were determined, showing four amino acid changes found only in CHIKV genomes obtained in MT since 2018: nsP2:T31I, nsP3: A388V, E3:T201I and E3:H57R, in addition to other mutations in E1, nsP2 and nsP4. Six parvovirus B19 (B19V) genotype I genomes (4771-5131 nt) showed four aa alterations (NS1:N473D, R579Q; VP1:I716T; and 11 kDa:V44A) compared to most similar B19V from the USA. Coinfection between CHIKV and B19V was evidenced in 22/65 (33.8%) patients by RTâPCR and PCR, respectively. Other viruses found in these pools include human pegivirus C, torque teno virus 3, an unclassified TTV and torque teno mini virus. Metagenomics represents a useful approach to detect viruses in the serum of acute febrile patients suspected of arbovirus disease.
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Fiebre Chikungunya , Virus Chikungunya , Virus , Humanos , Aminoácidos/genética , Brasil/epidemiología , Fiebre Chikungunya/epidemiología , Virus Chikungunya/genética , Fiebre , Genotipo , Mutación , Filogenia , Genoma ViralRESUMEN
Virus-like particles (VLPs) from Parvovirus B19 (B19V) can be obtained by the self-assembly of the structural proteins VP1 and VP2. It is possible to produce B19V VLPs either from VP2 or a mixture of VP1 and VP2, through its heterologous expression in eukaryotic cells. The difference between VP1 and VP2 protein is a tract of 227 residues located at the N-terminal region of VP1, known as the VP1 unique region (VP1u). This region is critical for B19V infection, including tropism, cell internalization, and lysosomal scape through its phospholipase 2A activity. Herein, we report the in vitro self-assembly of VP1 to form VLPs. These species have phospholipase activity, suggesting that the phospholipase domain is correctly folded. Furthermore, VP1 and VP2 were co-assembled to produce hybrid VLPs which were able to bind and internalize in the non-permissive HepG2 cells, another evidence of the functionality of the in vitro refolded VP1u.
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Parvovirus B19 Humano , Proteínas de la Cápside/metabolismo , Parvovirus B19 Humano/genética , FosfolipasasRESUMEN
Low levels of parvovirus B19 (B19V) DNA can be detected in the circulation and in different tissue of immunocompetent individuals for months or years, which has been linked to inflammatory diseases such as cardiomyopathy, rheumatoid arthritis, hepatitis, and vasculitis. However, the detection of B19V DNA does not necessarily imply that infectious virions are present. This study aimed to evaluate the method based on the Benzonase® treatment for differentiation between the infectious virions from "naked" DNA in serum and bone marrow (BM) samples to be useful for the B19V routine diagnosis. In addition, we estimated the period of viremia and DNAemia in the sera and bone marrow of nonhuman primates experimentally infected with B19V. Serum samples from ten patients and from four cynomolgus monkeys experimentally infected with B19V followed up for 60 days were used. Most of the human serum samples became negative after pretreatment; however, only decreased viral DNA loads were observed in four patients, indicating that these samples still contained the infectious virus. Reduced B19V DNA levels were observed in animals since 7th dpi. At approximately 45th dpi, B19V DNA levels were below 105 IU/mL after Benzonase® pretreatment, which was not a consequence of active B19V replication. The test based on Benzonase® pretreatment enabled the discrimination of "naked DNA" from B19V DNA encapsidated in virions. Therefore, this test can be used to clarify the role of B19V as an etiological agent associated with atypical clinical manifestations.
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Infecciones por Parvoviridae , Parvovirus B19 Humano , Médula Ósea , ADN Viral/genética , Humanos , Infecciones por Parvoviridae/diagnóstico , Parvovirus B19 Humano/genética , ViremiaRESUMEN
Resumen El parvovirus B19 es causante de una variedad de enfermedades exantemáticas durante la infancia y adolescencia, como el eritema infeccioso y el síndrome papular purpúrico en guante y calcetín. Este último es una acrodermatitis aguda, inusual y benigna, que puede asociarse a aftas orales, fiebre y otros síntomas constitucionales. Existen casos atípicos como la púrpura febril en otras localizaciones, sin cumplir la distribución característica en guante y calcetín de forma simétrica o con un mayor componente de eritrodermia. Presentamos el caso de una adolescente de 12 años con un síndrome papular purpúrico de distribución atípica por parvovirus B19.
Abstract Parvovirus B19 is the cause of a variety of exanthematous diseases during childhood and adolescence, such as erythema infectiosum and papular purpuric gloves and socks syndrome. This is an unusual, benign and acute acrodermatitis. Aphtous stomatitis, fever and other systemic symptoms can be associated with the eruption of the purpuric rash. Uncommon patterns such as asymmetrical distribution or erythematous involvement llave recently been described as additional features of PVB19-associated purpuric petechial eruption. This is a case report of a 12-year-old female with an atypical involvement of a papular-purpuric syndrome caused by human parvovirus B19.
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Humanos , Femenino , Niño , Púrpura/etiología , Parvovirus B19 Humano , Eritema Infeccioso/complicaciones , Eritema Infeccioso/diagnóstico , Dermatosis del Pie/complicaciones , SíndromeRESUMEN
An increasing number of reports have described human parvovirus B19 infection in association with a variety of neurological manifestations, especially in children. This study assessed the clinical and laboratory outcomes found in a case series of immunocompetent children who tested positive for parvovirus B19 by qualitative polymerase chain reaction assays of cerebrospinal fluid, in a tertiary referral center in the western Brazilian Amazon. We screened 178 children with clinically diagnosed central nervous system infections (meningoencephalitis). Of these, five (2.8%) were positive for parvovirus B19. A literature review also presented herein identified a further 50 cases of parvovirus B19 with neurological manifestations. Thus, even if the classic signs of parvovirus B19 infection are absent, such as the well-known rash, children with signs of neurological infection should also be evaluated for parvovirus B19 infection.
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Eritema Infeccioso , Enfermedades del Sistema Nervioso , Infecciones por Parvoviridae , Parvovirus B19 Humano , Niño , Eritema Infeccioso/diagnóstico , Humanos , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Reacción en Cadena de la PolimerasaRESUMEN
Resumen El Parvovirus B19 constituye un agente viral frecuente como causa de exantemas en edad pediátrica. Responsable clásicamente del eritema infeccioso, en los últimos años se lo asoció también a erupciones cutáneas atípicas. Recientemente se ha descrito una forma de exantema periflexural asociado a distintos agentes virales, conocido como síndrome Baboon-like. Presentamos el caso de una niña de 9 años con evidencia serológica de infección aguda por Parvovirus 19 que desarrolló una erupción máculo-pápulo-petequial con lesiones acentuadas en grandes pliegues. Se realiza búsqueda de la literatura disponible en relación a los exantemas inusuales por Parvovirus y se describe el caso como síndrome simil Baboon, una manifestación cutánea de esta infección viral.
Abstract Parvovirus B19 is a common viral cause of exanthem in pediatric patients. Classically responsible for infectious erythema, in the last few years it has also been associated with atypical rashes. A form of periflexural eruption associated with viral agents has been recently described as Baboon-like syndrome. We present the case of a 9-years-old girl with serological evidence of acute Parvovirus B19 infection that developed a maculopapular-petechial rash with lesions in large folds. A review of the available literature in relation to unusual Parvovirus exanthem is performed and the case is described as Baboon - like syndrome, a cutaneous manifestation of this viral infection.
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Resumen La infección por parvovirus humano B19 es una de las complicaciones comunes en pacientes diagnosticados de enfermedad de células falciformes (ECF). Se caracteriza por una anemia grave con reticulocitopenia, pudiendo estar acompañada de otras manifestaciones clínicas. En ocasiones, la infección puede ocurrir de modo simultáneo en contactos intrafamiliares de un paciente también con ECF. Es fundamental el reconocimiento temprano de esta complicación y el diagnóstico diferencial con otras patologías para su correcto manejo y tratamiento. Presentamos el caso de dos hermanos con ECF e infección por parvovirus humano B19.
Abstract Human parvovirus B19 infection is one of the common complications of patients diagnosed with Sickle cell disease (SCD). Parvovirus infections are characterized by a severe anemia with reticulocytopenia, sometimes presenting with other clinical manifestations. The infection can occur simultaneously in patient's cohabitants also diagnosed with SCD. Early recognition and differential diagnosis are essential for a proper disease management and treatment. We present two siblings with SCD and human parvovirus B19 infection.
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Humanos , Masculino , Niño , Parvovirus B19 Humano , Eritema Infeccioso , Infecciones por Parvoviridae , Anemia de Células Falciformes , Parvovirus B19 Humano/genética , Eritema Infeccioso/diagnóstico , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Hermanos , Anemia de Células Falciformes/complicacionesRESUMEN
Since the first evidence of human parvovirus B19 (B19V) infection in late 80s, several studies have been conducted to clarify the spectrum of clinical diseases in Brazil. B19V infection is prevalent in the general population and has exhibited a cyclical pattern of occurrence every 4-5 years, with the predominance of genotype 1 over 3b. During epidemic periods the wide range of clinical conditions, such as ertythema infectiosum, arthropathy, transient aplastic crisis, nonimmune hydrops fetalis and B19V-hepatitis were diagnosed. However, many infections are likely asymptomatic or have a self-limiting clinical course and are not readly diagnosed. Besides, the similarity of the symptoms of ertythema infectiosum to other rash diseases and the broadly circulation of arboviruses makes differential diagnosis more difficult. In this article, we provide a historical comprehensive overview of the research on parvovirus B19 conducted in Brazil, with a focus on the clinical and epidemiological aspects of the infection.