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Persistent B19 parvovirus infection in pediatric malignancies
K Broliden1, T Tolfvenstam, S Ohlsson
1Department of Clinical Virology, Swedish Institute for Infectious Disease Control, Stockholm, Sweden. Kristina.Broliden@smi.ki.se
Background And Procedure:
The frequency and clinical importance of parvovirus B19 infection were studied in children investigated or treated for various malignancies and cytopenias.
Results:
B19 infection was thus demonstrated in six out of 53 unselected children with malignancies by bone marrow examination, using the B19, DNA-specific, polymerase chain reaction (PCR). Examinations using the PCR in serum samples were equally or less sensitive than in bone marrow samples. One of the children had a persistent B19 infection during maintenance therapy for acute lymphoblastic leukemia. She developed a prolonged and severe cytopenia, and the clinical signs included facial rash, chills, high undulating fever, and pharyngitis. She also seroconverted and became B19 IgM-antibody positive during the study period.
Conclusions:
Parvovirus B19 infection was detected in 10% of the children and was either asymptomatic or was associated with severe and prolonged cytopenia. Bone marrow examinations are recommended for the detection of B19 DNA in immunosuppressed children.