Parvovirus B19 in Adults

Erythema infectiosum is usually a benign condition, parvovirus b19 in adults can also lead to Fifths disease or erythema infectiosum. It is a viral infection characterized by fever, arthralgia with edematous extremities. Transmission is primarily via respiratory secretions or infected blood.

The incubation period which is the time between the initial infection and the onset of symptoms is between 4 days to 3 weeks. Skin rash associated with erythema infectiousum can be present on extremities or cheeks. It is also known as  In normal healthy adults, the infection resolves without any complication. In anemic, pregnant and various immune compromised states there can be significant morbidity associated with.

In adults there is can be a severe flu like illness. Joint pains are much more common in adult women as compared to children with fifths disease. Treatment is symptomatic initially, with acetaminophen or NSAIDs such as ibuprofen. No specific antiviral treatment is recommended to treat parvovirus b19 in adults or children.

Intravenous immunoglobulin (IVIG) is used for patients with pure red cell aplasia due to parvovirus B 19. Sudden drop of hematocrit can be caused by parvovirus B 19 in patients with Sickle cell disease. The drop in hematocrit is as a result of lowered cell production i.e acute aplasia.

Immunocompetent individuals with prolonged rash and arthralgias caused by persistent viremia are selectively treated with Intravenous immunoglobulin (IVIG) and show good response with resolution of the illness associated with the viremia.

Blood counts to look for lowered hemoglobin/ hematocrit and raised TLC (Total Leucocyte Count) are usually done. ESR, anti CCP, ANA profile can also be advised especially if there are associated joint pains that have not responded to NSAIDs like ibuprofen for more than a week or if the joint pains have worsened despite treatment with Ibuprofen. Other possibilities such as Adult Stills disease, rheumatoid arthritis can also be kept in mind in such a situation.