RESUMEN
The use of oral fluid (OF) samples for serological diagnosis of parvovirus B19 infection during outbreaks of erythema infectiosum had already been demonstrated, but the feasibility of using OF for the characterization of B19 genotypes circulating during outbreaks has not been described. The aim of this study was to assess the use of "in-house" PCR-based assays as a powerful tool for a rapid diagnosis and molecular characterization of B19 strains in OF samples during outbreaks. Paired serum and OF samples collected from anti-B19 IgM-positive patients, during two outbreaks of ertythema infectiosum (1999-2000 and 2004-2005), were tested by conventional (cPCR) and quantitative PCR (qPCR). qPCR was more sensitive than cPCR for detecting B19-DNA in both OF and serum. Overall, OF presented lower viral load (9.97 × 106 UI/mL) than serum (2.42 × 1010 UI/mL) and this difference was statistically significant. All OF samples obtained from patients in the age group < 14 years presented low viral load (< 104 IU/mL). No correlation was found between viral load and the number of days of onset of rash. Sequence analysis from PCR positive OF samples confirmed the circulation of subgenotype 1a (G1a) during these outbreaks. Our findings indicate that PCR-based assays may fail to detect B19-DNA in approximately 50% of OF compared to serum samples. Nevertheless, our study has shown for the first time that the genome sequence of the amplicon from non-invasive clinical sample is useful for molecular genotyping and may be a tool to clarify the genetic diversity of B19 strains circulating in distinct outbreaks.
Asunto(s)
Eritema Infeccioso , Parvovirus B19 Humano , Humanos , Adolescente , Eritema Infeccioso/epidemiología , Eritema Infeccioso/diagnóstico , Parvovirus B19 Humano/genética , ADN Viral/genética , ADN Viral/análisis , Brotes de Enfermedades , Reacción en Cadena en Tiempo Real de la Polimerasa , Anticuerpos AntiviralesRESUMEN
Parvovirus B19 is the cause of a variety of exanthematous diseases during childhood and adolescence, such as erythema infectiosum and papular purpuric gloves and socks syndrome. This is an unusual, benign and acute acrodermatitis. Aphtous stomatitis, fever and other systemic symptoms can be associated with the eruption of the purpuric rash. Uncommon patterns such as asymmetrical distribution or erythematous involvement llave recently been described as additional features of PVB19-associated purpuric petechial eruption. This is a case report of a 12-year-old female with an atypical involvement of a papular-purpuric syndrome caused by human parvovirus B19.
Asunto(s)
Eritema Infeccioso , Dermatosis del Pie , Parvovirus B19 Humano , Púrpura , Adolescente , Niño , Eritema Infeccioso/complicaciones , Eritema Infeccioso/diagnóstico , Femenino , Dermatosis del Pie/complicaciones , Humanos , Púrpura/etiología , SíndromeRESUMEN
Resumen El parvovirus B19 es causante de una variedad de enfermedades exantemáticas durante la infancia y adolescencia, como el eritema infeccioso y el síndrome papular purpúrico en guante y calcetín. Este último es una acrodermatitis aguda, inusual y benigna, que puede asociarse a aftas orales, fiebre y otros síntomas constitucionales. Existen casos atípicos como la púrpura febril en otras localizaciones, sin cumplir la distribución característica en guante y calcetín de forma simétrica o con un mayor componente de eritrodermia. Presentamos el caso de una adolescente de 12 años con un síndrome papular purpúrico de distribución atípica por parvovirus B19.
Abstract Parvovirus B19 is the cause of a variety of exanthematous diseases during childhood and adolescence, such as erythema infectiosum and papular purpuric gloves and socks syndrome. This is an unusual, benign and acute acrodermatitis. Aphtous stomatitis, fever and other systemic symptoms can be associated with the eruption of the purpuric rash. Uncommon patterns such as asymmetrical distribution or erythematous involvement llave recently been described as additional features of PVB19-associated purpuric petechial eruption. This is a case report of a 12-year-old female with an atypical involvement of a papular-purpuric syndrome caused by human parvovirus B19.
Asunto(s)
Humanos , Femenino , Niño , Púrpura/etiología , Parvovirus B19 Humano , Eritema Infeccioso/complicaciones , Eritema Infeccioso/diagnóstico , Dermatosis del Pie/complicaciones , SíndromeRESUMEN
An increasing number of reports have described human parvovirus B19 infection in association with a variety of neurological manifestations, especially in children. This study assessed the clinical and laboratory outcomes found in a case series of immunocompetent children who tested positive for parvovirus B19 by qualitative polymerase chain reaction assays of cerebrospinal fluid, in a tertiary referral center in the western Brazilian Amazon. We screened 178 children with clinically diagnosed central nervous system infections (meningoencephalitis). Of these, five (2.8%) were positive for parvovirus B19. A literature review also presented herein identified a further 50 cases of parvovirus B19 with neurological manifestations. Thus, even if the classic signs of parvovirus B19 infection are absent, such as the well-known rash, children with signs of neurological infection should also be evaluated for parvovirus B19 infection.
Asunto(s)
Eritema Infeccioso , Enfermedades del Sistema Nervioso , Infecciones por Parvoviridae , Parvovirus B19 Humano , Niño , Eritema Infeccioso/diagnóstico , Humanos , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Reacción en Cadena de la PolimerasaRESUMEN
Human parvovirus B19 infection is one of the common complications of patients diagnosed with Sickle cell disease (SCD). Parvovirus infections are characterized by a severe anemia with reticulocytopenia, sometimes presenting with other clinical manifestations. The infection can occur simultaneously in patient's cohabitants also diagnosed with SCD. Early recognition and differential diagnosis are essential for a proper disease management and treatment. We present two siblings with SCD and human parvovirus B19 infection.
Asunto(s)
Anemia de Células Falciformes , Eritema Infeccioso , Infecciones por Parvoviridae , Parvovirus B19 Humano , Anemia de Células Falciformes/complicaciones , Eritema Infeccioso/diagnóstico , Humanos , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Parvovirus B19 Humano/genética , HermanosRESUMEN
Resumen La infección por parvovirus humano B19 es una de las complicaciones comunes en pacientes diagnosticados de enfermedad de células falciformes (ECF). Se caracteriza por una anemia grave con reticulocitopenia, pudiendo estar acompañada de otras manifestaciones clínicas. En ocasiones, la infección puede ocurrir de modo simultáneo en contactos intrafamiliares de un paciente también con ECF. Es fundamental el reconocimiento temprano de esta complicación y el diagnóstico diferencial con otras patologías para su correcto manejo y tratamiento. Presentamos el caso de dos hermanos con ECF e infección por parvovirus humano B19.
Abstract Human parvovirus B19 infection is one of the common complications of patients diagnosed with Sickle cell disease (SCD). Parvovirus infections are characterized by a severe anemia with reticulocytopenia, sometimes presenting with other clinical manifestations. The infection can occur simultaneously in patient's cohabitants also diagnosed with SCD. Early recognition and differential diagnosis are essential for a proper disease management and treatment. We present two siblings with SCD and human parvovirus B19 infection.
Asunto(s)
Humanos , Masculino , Niño , Parvovirus B19 Humano , Eritema Infeccioso , Infecciones por Parvoviridae , Anemia de Células Falciformes , Parvovirus B19 Humano/genética , Eritema Infeccioso/diagnóstico , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Hermanos , Anemia de Células Falciformes/complicacionesRESUMEN
BACKGROUND: Human Parvovirus B19 (B19V) is a common pathogen worldwide. After primary infection, B19V-DNA may permanently persist in non-erythroid tissues, including the liver of patients with acute liver failure (ALF). OBJECTIVE: To validate a real-time PCR (qPCR) for the quantification of B19V-DNA, in order to establish a differential diagnosis for B19V infection in ALF patients. METHODS: The qPCR techniques were based on Sybr Green® and TaqMan® methodologies. To evaluate the quality parameters of both methods, samples from patients with or without B19V infection were tested. The diagnostic utility of qPCR in the detection B19V-DNA in patients with ALF was evaluated by testing archived serum and hepatic tissue explants from 10 patients. RESULTS: The Sybr Green® methodology showed 97% efficiency, the limits of detection and quantification were 62.6 and 53,200 copies/mL, respectively. The TaqMan® methodology showed 95% efficiency, the limits of detection and quantification were 4.48 and 310 copies/mL, respectively. A false positive result was found only with the Sybr Green® methodology. Among ALF patients without defined etiology, three (30%) were positive for B19V DNA in serum and liver. CONCLUSION: The qPCR methods validated here were effective in clarifying uncommon cases of B19V-related ALF and are fit for differential diagnosis of ALF causes.
Asunto(s)
Eritema Infeccioso/diagnóstico , Fallo Hepático Agudo/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Parvovirus B19 Humano/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Sangre/virología , ADN Viral/genética , Diagnóstico Diferencial , Eritema Infeccioso/complicaciones , Eritema Infeccioso/virología , Humanos , Límite de Detección , Hígado/virología , Fallo Hepático Agudo/etiología , Fallo Hepático Agudo/virología , Técnicas de Diagnóstico Molecular/normas , Parvovirus B19 Humano/patogenicidad , Reacción en Cadena en Tiempo Real de la Polimerasa/normas , Estándares de Referencia , Reproducibilidad de los ResultadosRESUMEN
Parvovirus B19 is a DNA virus of the Parvoviridae family. We present four children with unusual exanthems associated with parvovirus infection: a purpuric periflexural pattern, a purpuric vasculitic pattern, and a combination of the two.
Asunto(s)
Eritema Infeccioso/diagnóstico , Parvovirus B19 Humano , Adolescente , Niño , Preescolar , Exantema/virología , Femenino , Humanos , MasculinoAsunto(s)
Eritema Infeccioso/diagnóstico , Infecciones por Mycoplasma/diagnóstico , Antibacterianos/uso terapéutico , Preescolar , Diagnóstico Diferencial , Exantema/etiología , Femenino , Enfermedad de Boca, Mano y Pie/diagnóstico , Humanos , Infecciones por Mycoplasma/tratamiento farmacológico , Neumonía por Mycoplasma/inmunologíaAsunto(s)
Eritema Infeccioso/diagnóstico , Exantema/etiología , Fiebre/etiología , Viaje , Adulto , Anticuerpos Antivirales/sangre , Infecciones por Arbovirus/diagnóstico , Colombia , Diagnóstico Diferencial , Eritema Infeccioso/sangre , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Pruebas Serológicas , EspañaRESUMEN
Em 18/08/2016, uma escola infantil notificou à vigilância do município de Crissiumal a ocorrência de vários casos de crianças com febre e exantema. A partir dessa informação, a equipe da vigilância, junto com médico da rede de atenção à saúde, deslocou-se até a escola para realizar avaliação clínica dos casos e fazer a investigação epidemiológica com vistas a confirmar a ocorrência de surto de doença exantemática, identificar a causa e desencadear medidas de controle. (AU)
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Guarderías Infantiles , Brotes de Enfermedades , Parvovirus B19 Humano , Eritema Infeccioso/epidemiología , Brasil/epidemiología , Eritema Infeccioso/diagnóstico , Eritema Infeccioso/prevención & control , Vacuna contra el Sarampión-Parotiditis-RubéolaAsunto(s)
Eritema Infeccioso/diagnóstico , Enfermedad Aguda , Niño , Preescolar , Diagnóstico Diferencial , Humanos , Lactante , Masculino , Factores de RiesgoRESUMEN
This study had the aim of investigating the frequency of measles, rubella, dengue and erythema infectiosum among suspected cases of measles and/or rubella in the state of Pernambuco, Brazil. A total of 1,161 serum samples collected between 2001 and 2004 were tested for these four viral diseases, using enzyme immunoassays to detect IgM antibodies. Out of this total, 276 (23.8%) samples were positive for one of the four viral diseases analyzed. There were 196 positive cases (16.9%) for dengue, 38 (3.3%) for erythema infectiosum (parvovirus B19), 32 (2.8%) for rubella and 10 (0.9%) for measles. Among the suspected cases of measles and rubella, dengue infection was the most frequent, followed by parvovirus B19. The similarity of the clinical manifestations among rash diseases contributes towards making it difficult to diagnose measles, rubella, dengue and erythema infectiosum on clinical grounds alone. It must be emphasized that the four tests used were insufficient for diagnosing 76.2% of the febrile and rash diseases notified. This is the first study bringing evidence of human parvovirus B19 circulation in Pernambuco.
Asunto(s)
Anticuerpos Antivirales/sangre , Dengue/epidemiología , Eritema Infeccioso/epidemiología , Inmunoglobulina M/sangre , Sarampión/epidemiología , Rubéola (Sarampión Alemán)/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Dengue/diagnóstico , Virus del Dengue/inmunología , Eritema Infeccioso/diagnóstico , Femenino , Humanos , Técnicas para Inmunoenzimas , Lactante , Masculino , Sarampión/diagnóstico , Morbillivirus/inmunología , Parvovirus B19 Humano/inmunología , Rubéola (Sarampión Alemán)/diagnóstico , Virus de la Rubéola/inmunología , Estaciones del AñoRESUMEN
Two atypical cases of parvovirus B19 infection occurred consecutively within a family. A 14 year-old patient presented an extended papular-purpuric "gloves and socks" syndrome and two weeks later his mother developed a predominantly unilateral purpuric rash in the limbs with severe malaise. Specific IgM antibodies in the boy and polymerase chain reaction (PCR) and serology in the mother, confirmed parvovirus B19 infection. We emphasize the variable presentation of B19 infection within a family. The importance of etiologic studies in the presence of atypical exanthemas and the utility of PCR in the diagnosis of B19 are underscored.
Asunto(s)
Eritema Infeccioso/diagnóstico , Exantema/diagnóstico , Dermatosis del Pie/virología , Dermatosis de la Mano/virología , Parvovirus B19 Humano , Púrpura/diagnóstico , Adolescente , Adulto , Eritema Infeccioso/virología , Exantema/virología , Familia , Femenino , Dermatosis del Pie/patología , Dermatosis de la Mano/patología , Humanos , Masculino , Parvovirus B19 Humano/genética , Reacción en Cadena de la Polimerasa , Púrpura/virología , SíndromeRESUMEN
O estudo teve como objetivo verificar a freqüência de sarampo, rubéola, dengue e eritema infeccioso entre casos suspeitos de sarampo e rubéola, no estado de Pernambuco, Brasil. Foram testadas 1.161 amostras de soro coletadas no período de 2001 a 2004, para as quatro viroses, utilizando-se ensaios imunoenzimáticos para detecção de anticorpos IgM. Desse total, 276 (23,8 por cento) amostras foram positivas para uma das quatro viroses analisadas. Foram detectados 196 (16,9 por cento) casos positivos para dengue, 38 (3,3 por cento) para eritema infeccioso (parvovírus B19), 32 (2,8 por cento) para rubéola e 10 (0,9 por cento) para sarampo. Entre os casos suspeitos de sarampo e rubéola, a infecção pelo vírus dengue foi a mais freqüente, seguida pelo parvovírus B19. A semelhança de manifestações clínicas entre as doenças exantemáticas contribui para dificultar o diagnóstico de sarampo, rubéola, dengue e eritema infeccioso, quando observados apenas os critérios clínicos. Deve-se salientar que os quatro testes utilizados foram insuficientes para diagnosticar 76,2 por cento das doenças febris exantemáticas notificadas. Este é o primeiro estudo que evidencia a circulação de parvovírus B19 humano em Pernambuco.
This study had the aim of investigating the frequency of measles, rubella, dengue and erythema infectiosum among suspected cases of measles and/or rubella in the state of Pernambuco, Brazil. A total of 1,161 serum samples collected between 2001 and 2004 were tested for these four viral diseases, using enzyme immunoassays to detect IgM antibodies. Out of this total, 276 (23.8 percent) samples were positive for one of the four viral diseases analyzed. There were 196 positive cases (16.9 percent) for dengue, 38 (3.3 percent) for erythema infectiosum (parvovirus B19), 32 (2.8 percent) for rubella and 10 (0.9 percent) for measles. Among the suspected cases of measles and rubella, dengue infection was the most frequent, followed by parvovirus B19. The similarity of the clinical manifestations among rash diseases contributes towards making it difficult to diagnose measles, rubella, dengue and erythema infectiosum on clinical grounds alone. It must be emphasized that the four tests used were insufficient for diagnosing 76.2 percent of the febrile and rash diseases notified. This is the first study bringing evidence of human parvovirus B19 circulation in Pernambuco.
Asunto(s)
Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Anticuerpos Antivirales/sangre , Dengue/epidemiología , Eritema Infeccioso/epidemiología , Inmunoglobulina M/sangre , Sarampión/epidemiología , Rubéola (Sarampión Alemán)/epidemiología , Brasil/epidemiología , Estudios Transversales , Virus del Dengue/inmunología , Dengue/diagnóstico , Eritema Infeccioso/diagnóstico , Técnicas para Inmunoenzimas , Sarampión/diagnóstico , Morbillivirus/inmunología , /inmunología , Virus de la Rubéola/inmunología , Rubéola (Sarampión Alemán)/diagnóstico , Estaciones del AñoRESUMEN
Two atypical cases of parvovirus B19 infection occurred consecutively within a family. A 14 year-old patient presented an extended papular-purpuric "gloves and socks" syndrome and two weeks later his mother developed a predominantly unilateral purpuric rash in the limbs with severe malaise. Specific IgM antibodies in the boy and polymerase chain reaction (PCR) and serology in the mother, confirmed parvovirus B19 infection. We emphasize the variable presentation of B19 infection within a family. The importance ofetiologic studies in the presence of atypical exanthemas and the utility of PCR in the diagnosis ofB19 are undesrscored.
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Masculino , Eritema Infeccioso/diagnóstico , Exantema/diagnóstico , Dermatosis del Pie/virología , Dermatosis de la Mano/virología , Púrpura/diagnóstico , Eritema Infeccioso/virología , Exantema/virología , Familia , Dermatosis del Pie/patología , Dermatosis de la Mano/patología , /genética , Reacción en Cadena de la Polimerasa , Púrpura/virología , SíndromeRESUMEN
Viral exanthems are a common problem in tropical regions, particularly affecting children. Most exanthems are transient and harmless, but some are potentially very dangerous. Pregnant women and malnourished or immunocompromised infants carry the greatest risk of adverse outcome. In this article, parvovirus B19; dengue and yellow fever; West Nile, Barmah Forest, Marburg, and Ebola viruses, and human herpesviruses; asymmetric periflexural exanthema of childhood; measles; rubella; enteroviruses; Lassa fever; and South American hemorrhagic fevers will be discussed.