Home > Skin nontumor > Parvovirus B19

Skin nontumor

Infectious disorders

Parvovirus B19

Authors: Abha Soni, D.O., M.P.H., Mowafak Hamodat, M.B.Ch.B., M.Sc.

Last author update: 1 May 2016

Last staff update: 16 November 2020

Copyright: 2002-2025, PathologyOutlines.com, Inc.

PubMed Search: Parvovirus B19 [title]

Table of Contents

Cite this page: Soni A, Hamodat M. Parvovirus B19. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorparvovirus.html. Accessed January 16th, 2025.

Definition / general

Viral infection that typically causes mild rash in children

Terminology

Clinical syndrome is called "Fifth disease" or erythema infectiosum

Etiology

Parvovirus B19 is spread by respiratory droplets, and has an incubation period of 5 - 14 days
Viral receptor is the erythrocyte P antigen, which is expressed on endothelial cells
Parvovirus attacks erythroblasts; may cause acute anemic crisis in patients with accelerated erythropoiesis, immunocompromised or minimal reserve (chronic anemia, hemolytic anemia, sickle cell, fetuses), although usually recipients have no symptoms (Transfusion 2005;45:1811)
Pregnant women may pass virus to fetus, where it may cause marked fetal anemia and hydrops
Rash may be due to delayed type hypersensitivity, antibody dependent cellular immunity against microbial antigens in epidermis or endothelium, or circulating immune complexes

Clinical features

Causes "Fifth disease" in children, a mild illness with a "slapped cheek" facial rash
Characteristic skin manifestations are petechial eruption in a glove and stocking distribution, reticular truncal erythema and "slapped cheek" sign (Hum Pathol 2000;31:488)
May produce influenza-like illness, miscarriage, fetal hydrops and neonatal angioedema
Atypical presentations include generalized petechial rash (Pediatrics 2010;125:e787), asymptomatic papular eruption or lower extremity palpable purpura, red baby syndrome (Indian J Pediatr 2009;76:309), papular purpuric gloves and socks syndrome (Med Oral Patol Oral Cir Bucal 2007;12:E4); may resemble Sweet syndrome, myopathic dermatomyosis or lupus erythematosus (Intern Med 1998;37:708)
Immune responses usually clear infection and provide lifelong protection but virus may persist in blood or tissue (Transfus Med 2007;17:263)
Parvovirus B19 has been associated with some cases of Rosai-Dorfman disease (J Clin Pathol 2006;59:1320)

Case reports

Parvovirus and acute hepatic failure in two children (Am J Transplant 2014;14:2645)
Parvovirus B19 induced transient anemia in an immunocompetent child (Turk Patoloji Derg 2015;31:158)
Parvovirus B19 in children with sickle cell anemia (Exp Biol Med (Maywood) 2016;241:749)
Sudden cardiac death from parvovirus in a young man with Brugada syndrome (J Forensic Leg Med 2014;25:8)

Treatment

Usually self resolving
Can treat symptoms of fever, joint pain, swelling and itching
Children and healthy adults have complete recovery

Clinical images

Images hosted on other servers:

Lace-like rash on extremities

Microscopic (histologic) description

Interstitial histiocytic infiltrate with piecemeal fragmentation of collagen and mononuclear cell-predominant vascular injury pattern
Extravasated red blood cells
Erythrocyte precursors may have intranuclear inclusions
Eosinophils and occasional neutrophils may be present
Perineuritis may also be present
Also interface dermatitis, eczematous alterations, papillary dermal edema; occasionally mesenchymal mucinosis, leukocytoclastic vasculitis

Microscopic (histologic) images

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