Neurological Manifestations Associated with Parvovirus B19 Infection in Immunocompetent Children: Case Series and Systematic Review

Monteiro, Vinícius Silva; Baía-da-Silva, Djane Clarys; Silva, Valderjane Aprigio; João, Guilherme Augusto Pivoto; Marinho, Eveny Perlize Melo; Cubas-Vega, Nadia; Val, Fernando; Perez-Gomez, Aline Stephanie; Monte, Rossiclea Lins; Mota, Adolfo José da; Lacerda, Marcus Vinícius Guimarães; Bastos, Michele Souza

doi:10.1093/tropej/fmab078

Cited by 6 publications

(13 citation statements)

References 72 publications

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“…Her CSF also revealed pleocytosis with increased protein and lactate, and normal glucose levels. These findings are in agreement with prior descriptions of Parvovirus B19 CNS infection [14], [28], [29], [30]. In blood tests, a decrease in hemoglobin with levels below 10 g/dL, and anisocytosis was observed , as reported in the literature [14], [31,32].…”

Section: Discussionsupporting

confidence: 93%

“…In our series of 600 CSF samples from acute CNS infections B19 was identified in only a single sample (0.17%). In other case series, this virus has been identified as a pathogen associated with undiagnosed meningoencephalitis, reaching a prevalence rate of up to 4.3% [14], [26], [27] , a frequency higher than that obtained in our series.…”

Section: Discussioncontrasting

confidence: 69%

“…The percentage of cases due to B19 infection are often mistakenly reported [12,13]. In Brazil, neurological consequences of a parvovirus B19 infection are considered rare, but laboratory tests are not always available to rule out their occurrence [14].…”

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confidence: 99%

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Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated With Haemophilus influenzae Meningitis in a Newborn

Ferreira¹,

Costa²,

Kallás³

et al. 2023

Preprint

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Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymp-tomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are com-mon to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl ad-mitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admis-sion and discontinued after negative laboratory results were obtained. Nine days after symp-toms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations, and emphasizes that its possible involve-ment might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 69%

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Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated With Haemophilus influenzae Meningitis in a Newborn

Ferreira¹,

Costa²,

Kallás³

et al. 2023

Preprint

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“…8,11 Moreover, a case of PVB19 encephalitis has been reported with normal MRI brain findings. 1 Systematic review and case series analysis in immunocompetent children with neurological manifestations of PVB19 by Monteiro et al 2 have not found any objective assessment of the efficacy of IVIG and/ or steroids for therapy. This has been consistent with other reviews by Barah et al 5 and Watanabe et al 6 However, several cases have noted clinical improvement in children with PVB19-associated neurological symptoms.…”

Section: Discussionmentioning

confidence: 99%

Fever, Seizures, and Basal Ganglia Lesions

Subramanian,

Rakheja,

Leifso

et al. 2023

Clin Pediatr (Phila)

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We describe the case of a previously healthy 17-year-old boy admitted to the hospital after a generalized tonicclonic seizure that followed a 3-day history of fever, malaise, and headache.At presentation, he was in no distress with a heart rate of 75 beats per minute, respiratory rate of 14 breaths per minute, temperature of 36.5 °C, oxygen saturation on room air at 99%, and blood pressure of 127/ 82 mm Hg. His Glasgow Coma Score (GCS) was 13, with disorientation to time and place. His receptive language was intact. However, he had difficulty finding words and responded with one-word answers. He had both long and short-term memory loss but no focal neurological signs. Pupils were equal and reactive to light, with normal range of eye movement and no nystagmus. Fundoscopy was normal. There was no facial asymmetry or tongue fasciculations. He had normal tone, muscle bulk, power 5/5, and reflexes 2+ in the upper and lower limbs. Sensation, gait, and coordination were intact. There were no abnormal movements or meningeal signs. Brudzinski and Kernig signs were not elicited. A complete cardiorespiratory and gastrointestinal exam was unremarkable. There was no rash, joint tenderness or swelling.Investigations at presentation showed high white blood cell count of 11.8 × 10 9 / L, neutrophils at 7.7 × 10 9 / L, lymphocytes at 2.9 × 10 9 / L, hemoglobin of 146 g/L, and platelet of 194 × 10 9 / L. Cerebrospinal fluid (CSF) cell count was elevated at 54 × 10 6 /L, protein was high at 0.64 g/L, and glucose was 2.8 mmol/L. Repeat labs revealed mild anemia on day 4 of admission (lowest hemoglobin 134 g/L, hematocrit 0.385), which resolved without interventions by day 10 of admission.

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“…In the breeding industry, goose parvovirus often causes huge economic losses due to large-scale epidemic in different regions [ 2 ]. Pregnant women are susceptible to human parvovirus B19, and it can be transmitted to the fetus after infection causing aplastic anemia[ 3 – 5 ]. Parvoviruses are important pathogens leading to animal diseases and have a significant role in gene therapy, oncolytic therapy, vaccine development, and as passive immune vectors [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Progress in the study of parvovirus entry pathway

Shi

Pei

et al. 2023

Virol J

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A group of DNA viruses called parvoviruses that have significant effects on cancer therapy and genetic engineering applications. After passing through the cell membrane to reach the cytosol, it moves along the microtubule toward the nuclear membrane. The nuclear localization signal (NLS) is recognized by importin-beta (impβ) and other proteins from the complex outside the nuclear membrane and binds to enter the nucleus via the nuclear pore complex (NPC). There are two main pathways for viruses to enter the nucleus. The classical pathway is through the interaction of imp α and impβ with NLS via NPC. The other is the NPC mediated by the combination of impβ and it. While the capsid is introduced into the nucleus through classical nuclear transduction, there is also a transient nuclear membrane dissolution leading to passive transport into the nucleus, which has been proposed in recent years. This article mainly discusses several nuclear entry pathways and related proteins, providing a reference for subsequent research on viral entry pathways.

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Neurological Manifestations Associated with Parvovirus B19 Infection in Immunocompetent Children: Case Series and Systematic Review

Cited by 6 publications

References 72 publications

Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated With Haemophilus influenzae Meningitis in a Newborn

Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated With Haemophilus influenzae Meningitis in a Newborn

Fever, Seizures, and Basal Ganglia Lesions

Progress in the study of parvovirus entry pathway

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