Acute human parvovirus B-19 infection in hospitalized children - A serologic and molecular survey
Acute human parvovirus B-19 infection in hospitalized children - A serologic and molecular survey
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DOI：
10.1097/01.inf.0000237865.01251.d2
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发表时间：
2006-10-01
影响因子：
3.6
通讯作者：
Schlesinger, Yechiel
中科院分区：
文献类型：
--
作者：
Miron, Dan;Luder, Anthony;Schlesinger, Yechiel
Background: The extent and clinical manifestations of acute human parvovirus B19 (B 19) infection were assessed in previously healthy hospitalized children admitted with clinical syndromes potentially associated the virus.Patients and Methods: The study was prospective and was conducted between October 2002 and August 2004 in the pediatric departments of 3 hospitals in Israel. The survey included previously healthy children who were hospitalized with 1 or more of the following acute diseases: acute nonallergic exanthema, fever for > 1 week, aplastic anemia or pancytopenia, acute nonbacterial arthropathy, immune thrombocytopenic purpura (ITP), Henoch-Schonlein purpura (HSP) and aseptic meningitis. A control group of children with a proven, non-1319 infection was also studied. Serum samples obtained from each child on admission were tested for B19 DNA by real-time PCR and B19 IgM by ELISA. Acute B19 infection was defined by the following criteria: positive serum B19-DNA and/or B19 IgM, negative serum B19 IgG, and no other proven infection.Results: Overall, 167 children were included in the study. The mean age was 5.5 +/- 4.6 years (range, 0.5-17), males and females equally divided. Acute B19 infection was demonstrated in 12.6% (n = 21) of the children. Both tests were performed in 19 children and were positive in 10 (53%). In 7 and 2 children, only B19-DNA or B19 IgM, respectively, was positive. Acute B19 infection was documented in 27% (10/39) of children who presented with a variety of acute exanthema diseases; 9% (5/57) of children with acute arthropathy (all 5 had transient synovitis); 10% (2/2 1) of children with fever > 1 week, both presented as mononucleosis syndrome; and in 44% (4/9) of children with transient pancytopenia or aplastic anemia. No acute B19 infection was demonstrated in 15 children with ITP, 9 with HSP, and 6 with aseptic meningitis and among 70 children in the control group. By logistic regression analysis, manifestations significantly associated with acute B19 infection were exantherna (OR 2.9; 95% CI = 1.1-7.5), anemia (OR 6.351- 95% CI=2.2-18.2) and leucopenia (OR 4.14; 95% CI = 1.2-14.2).Conclusions: Acute B19 infection was documented among 12.6% of children hospitalized with clinical syndrome potentially associated with the virus. Clinical and laboratory features associated with acute B19 infection were exanthema, anemia and leucopenia. Determination of both serum B19-DNA and serum B19 IgM should be performed for the accurate diagnosis of acute B19 infection.
