Acute Parvovirus B19 Infection Associated with Multi-Organ Involvement in an Immunocompetent Adult

Human parvovirus B19 is a highly prevalent single-stranded deoxyribonucleic acid virus that infects a large proportion of the global population. It can involve multiple organ systems, leading to a broad spectrum of clinical manifestations. While most infections in immunocompetent individuals are mild and self-limiting, parvovirus B19 can occasionally cause severe and diverse complications.

We present a case of a 44-year-old, immunocompetent woman, who presented acutely with a severe acute inflammatory response associated with hepatomegaly, oedema, and cardiac and renal involvement. Early suspicion of atypical infections including parvovirus B19 was considered given the multi-organ involvement and non-specific aetiology. Parvovirus B19 infection was confirmed alongside the development of the typical rash seen in acute infection and the patient improved with supportive therapy with full resolution.

This case underscores the potential severity of parvovirus B19 infection. Early testing and a high index of suspicion is required to accurately diagnoses these patients and may improve clinical outcomes whilst the mainstay of management is supportive. A potential underlying pathophysiology is suggested in acute parvovirus B19 infection with multi-organ involvement highlighting the link between infection and cytokine-driven inflammation and endothelial dysfunction.

Early testing for parvovirus B19 should be considered in immunocompetent adults with features of acute hepatitis of unknown aetiology, especially when there is early haematological and joint involvement.In patients with acute infection with parvovirus B19, cytokine-driven inflammation and endothelial dysfunction can result in extremis and multi-organ involvement.Supportive treatment and close monitoring is the mainstay of treatment for patients identified and early escalation to intensive care may be required.