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Fulminant disseminated human parvovirus B19 infection: Case report
Yan Chen1, Wei Jiang1, Li Weng1
1Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Background:
Fulminant, disseminated Human parvovirus B19 (HPV B19) infection is uncommon and can be fatal if unrecognized.
Case Presentation:
A 35-year-old man developed abrupt confusion on the second day of incarceration. He was admitted to intensive care with acute kidney, liver injury, coagulopathy, thrombocytopenia, and persistent hematochezia. The etiology remained unclear until next-generation sequencing detected HPV B19 DNA in blood, cerebrospinal fluid (CSF), bronchoalveolar lavage fluid, and ascitic fluid. On illness Day 32, B19 infection was confirmed by quantitative PCR from blood, CSF, and a rectal biopsy. Despite negative B19-specific IgM, the patient improved after four weeks of supportive care and two courses of intravenous immunoglobulin, with recovery of renal, hepatic, and respiratory function and resolution of rectal lesions.
Conclusions:
Disseminated HPV B19 infection should be considered in unexplained multiorgan dysfunction, even in the absence of rash or IgM seroconversion. Early PCR-based testing of blood and affected tissues can be diagnostic.
