Neurologic manifestations associated with parvovirus B19 infection.
Eighty-one cases of neurologic disease, including encephalitis, meningitis, stroke, and peripheral neuropathy, that were associated with parvovirus B19 infection were reviewed. Most patients were children, and two-thirds had central nervous system manifestations. One-third had altered immunity. Viral symptoms (odds ratio [OR], 5.7; P= .002), rash (OR, 11.5; P< .001), and peripheral nervous system involvement (OR, 12.1; P= .004) were more frequent in immunocompetent patients. Brain magnetic resonance imaging abnormalities were more frequent in patients with altered immunity (OR, 10; P= .04). In central nervous system disease, parvovirus B19 DNA was commonly detected in cerebrospinal fluid (81% of samples) and serum (85%), whereas specific antibodies were found in 33% of cerebrospinal fluid samples. Neurologic sequelae occurred in 22% of 77 patients with a known outcome, and some improvement occurred in 16%. No differences in the prevalence of sequealae were noted between immunocompetent patients (21% of whom experienced sequealae) and patients with altered immunity (25%) or between patients with central nervous system manifestations who received intravenous immunoglobulin with or without steroids and those patients with central nervous system manifestations who did not. Five patients died.
Department of Pediatrics, Division of Pediatric Infectious Diseases, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Ave., Rosenthal 4th Fl., Bronx, New York 10467, USA. mdouvoyi@montefiore.org
Miltiadis
M
Douvoyiannis
Nathan
N
Litman
David L
DL
Goldman
D000293:Adolescent; D000328:Adult; D000368:Aged; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000150:complications* / Q000821:virology*; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D016896:Treatment Outcome; D055815:Young Adult