Meningoencephalitis with Persistent Parvovirus B19 Infection in an Apparently Healthy Woman

Bonvicini, Francesca; Marinacci, Ginevra; Pajno, Maria Chiara; Gallinella, Giorgio; Musiani, Monica; Zerbini, Marialuisa

doi:10.1086/589863

Cited by 16 publications

(15 citation statements)

References 9 publications

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“…Reversal of the abnormal magnetic resonance imaging findings within 8 days [19] and clinical improvement with simultaneous clearance of viremia after IVIG administration were also described [23,58].…”

Section: Epidemiologymentioning

confidence: 93%

“…Seizures usually were generalized, but in 5 cases, partial motor seizures involving an extremity occurred [16,17,58,60]. Localized neurologic signs included hemiparesis [51,58], paresis of the facial muscles [7], chorea affecting the face and the upper limbs [10], opsoclonus [59], diplopia, nystagmus [56], optic neuritis [50], paresthesias [23,50], and apraxia and aphasia [50,55].…”

Section: Epidemiologymentioning

confidence: 99%

“…The time to clinical improvement after IVIG administration varied, occurring as early as 2 days after administration in patients with encephalitis and several days after administration in patients with neuropathies [19,21,23]. Reversal of the abnormal magnetic resonance imaging findings within 8 days [19] and clinical improvement with simultaneous clearance of viremia after IVIG administration were also described [23,58].…”

Section: Epidemiologymentioning

confidence: 99%

“…Recurrence of meningoencephalitis and brachial plexus neuritis occasionally occurred during tapering of steroids [23,40]. In contrast, encephalopathy and brachial plexus neuritis were reported in 2 patients who received steroids for their underlying disease [58,61].…”

Section: Epidemiologymentioning

confidence: 99%

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Neurologic Manifestations Associated with Parvovirus B19 Infection

2009

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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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Section: Epidemiologymentioning

confidence: 93%

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

See 2 more Smart Citations

Neurologic Manifestations Associated with Parvovirus B19 Infection

2009

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“…Most frequently immunocompromised patients seem to be affected. Interestingly, there is an increasing number of reports on immunocompetent humans with parvovirus B19 infection and associated neurological signs (7,25). Brain cell susceptibility for parvovirus infection and the underlying pathogenesis still awaits further understanding.…”

mentioning

confidence: 99%

Leukoencephalopathy Associated with Parvovirus Infection in Cretan Hound Puppies

Schaudien¹,

Polizopoulou

Koutinas

et al. 2010

J Clin Microbiol

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Leukoencephalopathies in dogs encompass presumably inherited conditions such as leukodystrophies, hypomyelination or spongiform degeneration, but other causes, such as virus infections and toxic or nutritional factors, might also play a contributory role. In this report, we provide evidence of parvovirus infection and replication in the brains of five 6-week-old Cretan hound puppies suffering from a puppy shaker syndrome and leukoencephalopathy. Although these puppies belonged to two different litters, they were closely related, tracing back two generations to the same sire. Histologically, a mild to moderate lymphohistiocytic meningitis, with focal lymphohistiocytic leukoencephalitis in two animals, and a mild to moderate vacuolation with myelin loss, mainly in the white matter of the cerebellum was detected. Vacuolation was also found in the corpus callosum, fimbria hippocampi, mesencephalon, capsula interna, basal ganglia, and hypothalamus.

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Neurological aspects of human parvovirus B19 infection: a systematic review

Barah

Whiteside

Batista

et al. 2014

Reviews in Medical Virology

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Parvovirus B19 has been linked with various clinical syndromes including neurological manifestations. However, its role in the latter remains not completely understood. Although the last 10 years witnessed a surge of case reports on B19-associated neurological aspects, the literature data remains scattered and heterogeneous, and epidemiological information on the incidence of B19-associated neurological aspects cannot be accurately extrapolated. The aim of this review is to identify the characteristics of cases of B19-associated neurological manifestations. A computerized systematic review of existing literature concerning cases of B19-related neurological aspects revealed 89 articles describing 129 patients; 79 (61.2%) were associated with CNS manifestations, 41 (31.8%) were associated with peripheral nervous system manifestations, and 9 (7.0%) were linked with myalgic encephalomyelitis. The majority of the cases (50/129) had encephalitis. Clinical characteristic features of these cases were analyzed, and possible pathological mechanisms were also described. In conclusion, B19 should be included in differential diagnosis of encephalitic syndromes of unknown etiology in all age groups. Diagnosis should rely on investigation of anti-B19 IgM antibodies and detection of B19 DNA in serum or CSF. Treatment of severe cases might benefit from a combined regime of intravenous immunoglobulins and steroids. To confirm these outcomes, goal-targeted studies are recommended to exactly identify epidemiological scenarios and explore potential pathogenic mechanisms of these complications. Performing retrospective and prospective and multicenter studies concerning B19 and neurological aspects in general, and B19 and encephalitic syndromes in particular, are required. © 2014 The Authors. Reviews in Medical Virology published by John Wiley & Sons, Ltd.

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Meningoencephalitis with Persistent Parvovirus B19 Infection in an Apparently Healthy Woman

Cited by 16 publications

References 9 publications

Neurologic Manifestations Associated with Parvovirus B19 Infection

Neurologic Manifestations Associated with Parvovirus B19 Infection

Leukoencephalopathy Associated with Parvovirus Infection in Cretan Hound Puppies

Neurological aspects of human parvovirus B19 infection: a systematic review

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