TY - JOUR
T1 - Neurologic manifestations associated with parvovirus B19 infection
AU - Douvoyiannis, Miltiadis
AU - Litman, Nathan
AU - Goldman, David L.
PY - 2009/6/15
Y1 - 2009/6/15
N2 - 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.
AB - 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.
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U2 - 10.1086/599042
DO - 10.1086/599042
M3 - Article
C2 - 19441978
AN - SCOPUS:66949144407
SN - 1058-4838
VL - 48
SP - 1713
EP - 1723
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 12
ER -