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Parvovirus B19 (B19V) infection is the cause of erythema infectiosum, or the "fifth disease", a widespread infection, potentially affecting 1-5% of pregnant women, in most cases without significant damage to the pregnancy or fetus. It follows a seasonal variation, with a higher prevalence in temperate climates, mainly in late winter and early spring. Women at increased risk include mothers of preschool and school-age children, and those working in nurseries, kindergartens, and schools.

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Parvovirus B19 infection in children: a comprehensive review of clinical manifestations and management.

Ital J Pediatr

December 2024

Department of Pediatrics, Santa Maria delle Croci Hospital, AUSL della Romagna, Viale Vincenzo Randi, 5, Ravenna, Ravenna, 48121, RA, Italy.

Parvovirus B19 (B19V) is a significant pathogen responsible for a wide range of clinical manifestations, particularly in children and pregnant women. While B19V is most commonly recognized as the cause of Fifth disease, a mild erythematous illness in children, its clinical impact extends far beyond this condition. B19V can lead to severe complications, including transient aplastic crisis in individuals with chronic hemolytic anemias, arthralgia, and more severe joint diseases.

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Human parvovirus B19 typically causes erythema infectiosum, but unusual exanthems and hemorrhagic manifestations, such as purpuric-petechial rashes, have also been reported. PVB19-associated purpuric-petechial eruption (PAPPE) should be recognized as a distinct clinical feature of primary parvovirus B19 infection and considered in the differential diagnosis of patients with febrile purpura. This report aims to highlight several scenarios of B19V-associated petechial and purpuric rashes, which may present to pediatric departments during outbreaks.

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Introduction: parvovirus B19 (B19V) infection during pregnancy can be transmitted to the fetus and cause serious complications such as fetal hydrops and stillbirth. The preexistence of specific IgG prevents vertical transmission. Seroprevalence in fertile age is variable (50-70%) and depends on the region/viral circulation, in addition to factors such as maternal age and frequent exposure to children.

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Article Synopsis
  • Acute myocarditis cases in kids are increasing in Italy, with 65 suspected cases reported in 2024, largely linked to parvovirus B19 infection.
  • Among these cases, 29 children needed intensive care and there were eight fatalities, emphasizing the severity of the situation.
  • The study suggests a need for better diagnosis, enhanced monitoring, and standardized treatment strategies, as only about one-third of affected children received effective intravenous immunoglobulins.
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