Parvovirus infections. From benign to life-threatening

Erythema infectiosum, aplastic crisis, intrauterine fetal demise, and an acute polyarthralgia syndrome can all be caused by human parvovirus B19. The major pathophysiologic effect of infection seems to be cessation of erythropoiesis as a result of cytolytic infection of red cell precursors. Erythema infectiosum is a benign disease that usually occurs in childhood. The acute polyarthralgia syndrome is likewise benign, and patients in whom parvovirus infection has been confirmed by serologic testing can be reassured that their joint symptoms are likely to be self-limited. Parvovirus-induced aplastic crisis in a patient with chronic hemolytic anemia is life-threatening but can be reversed with blood transfusions if recognized promptly. Parvovirus infection during pregnancy clearly increases the risk of fetal demise, and parental anxiety is understandably high. An organized approach using a combination of tests to monitor mother and fetus can provide optimal care in these cases.