Not Always 'Slapped Cheeks': Parvovirus B19 Infection Causing Severe Anaemia in a Kidney Transplant Recipient

Infections are a significant cause of morbidity and mortality in kidney transplant patients. The clinical presentation can be atypical, and establishing the diagnosis in a timely manner can be challenging. We describe a 55-year-old woman who received a kidney transplant and developed severe anaemia with very high ferritin levels, abnormal liver function tests and no evidence of bleeding. Initial screening for parvovirus infection with IgG and IgM antibodies was negative, but blood DNA polymerase chain reaction (PCR) for parvovirus was strongly positive with a high viral load. Treatment with reduction in immunosuppressive therapy and a course of intravenous immunoglobulin resulted in sustained improvement in haemoglobin levels and a reduction in viral load. This case report highlights the diagnostic and management challenges of parvovirus infection in a kidney transplant recipient.