Human Parvovirus B19 Infection in 15 Adults ―Two-year Toho University Hospital Study ―

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  • NAGAI Yohko
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • HARA Noriko
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • MAEDA Tadashi
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • IWATA Motohide
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • DOMON Kaoru
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • ISHII Takamasa
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • YOSHIZAWA Sadako
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • AKIMOTO Tatsuo
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • KATO Hirohito
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • URITA Sumihisa
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • NAKANISHI Kazushige
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine
  • SUGIMOTO Motonobu
    Department of General Medicine and Emergency Care, Toho University, Faculty of Medicine

Bibliographic Information

Other Title
  • 当科で2 年間に経験した成人ヒトパルボウイルスB19 感染症15 症例の検討
  • 当科[東邦大学医学部総合診療科]で2年間に経験した成人ヒトパルボウイルスB19感染症15症例の検討
  • トウカ トウホウ ダイガク イガクブ ソウゴウ シンリョウカ デ 2ネンカン ニ ケイケンシタ セイジン ヒトパルボウイルス B19 カンセンショウ 15 ショウレイ ノ ケントウ

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Abstract

Human parvovirus B19 infection in adults features clinical symptoms and laboratory abnormal findings unlike those in children commonly associated with cheek rash. We diagnosed 15 adult cases based on the positive increase in anti-parvovirus B19 IgM antibody (8.89±7.86 mean±SD, enzyme immunoassay (EIA)). Antibody titer was measured in 78 patients clinically showing fever, edema, exanthema, arthralgia, and myalgia among 11,040 outpatients first visiting the hospital from January 2005 to December 2007. Based on clinical and laboratory findings for these 15 cases, we recommended that physicians taking anti-parvovirus B19 antibody blood samples note whether (1) the level of C reactive protein is negative or low and without leucocytosis ; (2) a miliary rash is observed in short duration (rarely facial) ; (3) arthralgia and/or myalgia is present in the extremities (sometimes asymmetrical) ; (4) edema is present in the extremities, especially finger, ankle, or sole of the foot ; (5) contact has been made with ill children ; (6) flu-like symptoms occur such as fatigue, headache, or fever ; and (7) normo- or hypocomplementemia and/or antinuclear antibody is positive. Patients who fullfill requirement (1) plus at least three of requirements (2) through (7) should have a blood sample taken. We retrospectively studied 78 cases using these requirements, finding their sensitivity to be 100％(15/15), specificity to be 88.9％(56/63), positive predictive value to be 68.1％(15/22) and negative predictive value to be 100％(56/56). These requirements are thus useful in selecting patients for measuring antibody titer and definitively diagnosing severe or persistent parvovirus B19 infection occationally observed in adults.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 83 (1), 45-51, 2009

    The Japanese Association for Infectious Diseases

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