Human parvovirus B19 vertical infection and hydrops fetalis. A case report.

Arch Argent Pediatr

Instituto de Virología Dr. J. M. Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.

Published: October 2024

AI Article Synopsis

  • * A case is presented where a 30-year-old mother with anemia and hydrops fetalis delivered a preterm baby, but initial maternal testing for B19V was misleading, showing only IgG and no IgM.
  • * Ultimately, postnatal testing confirmed B19V infection in the newborn, highlighting the need for updated screening protocols that include early molecular tests to better diagnose and manage congenital infections.

Article Abstract

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.

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Source
http://dx.doi.org/10.5546/aap.2024-10420.engDOI Listing

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