title: Detection of parvovirus B19 in the lower respiratory tract.
abstract: BACKGROUND
  Human parvovirus B19 infection generally displays a self-limiting course followed by viral clearance; although, in some cases, persistent infection may occur. Few cases of severe pulmonary disease following primary infection in both immunocompetent and immunocompromised patients were reported.
  
  
  OBJECTIVE
  To investigate the prevalence and clinical impact of parvovirus B19 in the lower respiratory tract.
  
  
  METHODS
  The prevalence of parvovirus B19-DNA was evaluated by Real-Time PCR in 264 bronchoalveolar lavages (BAL) from 189 adult patients over a full-year period and related to demographic characteristics, underlying pathologies, immune status, admission to intensive care unit, mortality within 28 days, and discharge diagnosis.
  
  
  RESULTS
  Parvovirus B19-DNA was detected in 7/189 (3.7%) patients, without significant association to demographic characteristics, immune status, transplant versus non-transplant status, admission to intensive care unit, presence of haematological conditions. In two lung transplant recipients surveillance specimens were positive to B19. Four of the remaining five patients presented respiratory insufficiency. A significant association to mortality was found, as 3/7 (42.9%) positive patients died within 28 days. No patient presented serological evidence of recent or acute infection and viremia.
  
  
  CONCLUSIONS
  Parvovirus B19 may be detected at low frequency in BAL specimens from patients with different pathological backgrounds. This finding could be due to chronic infection with virus persistence in the lower respiratory tract, also in the absence of symptoms unequivocally attributable to B19. The high rate of mortality warrants the need for further studies to evaluate the opportunity to consider parvovirus B19 in the diagnostic work-up of lower respiratory tract infections.
authors.affiliation: Virology Unit, Department of Public Health and Microbiology, University Hospital San Giovanni Battista di Torino, Turin, Italy. cristina.costa@unito.it
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Terlizzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Solidoro
authors.forename: Daniela
authors.initials: D
authors.lastname: Libertucci
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Bergallo
authors.forename: Rossana
authors.initials: R
authors.lastname: Cavallo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology*; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000453:epidemiology / Q000821:virology*; D016732:Parvovirus B19, Human / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000821:virology*
chemical_list: D004279:DNA, Viral