Tasty Morsels of EM 045 – Parvovirus B19

As always, this is from the ever expanding google doc on bits and bobs I read and learn from and transfer here for all our learning pleasure.

Everyone knows the slapped cheek syndrome that runs in epidemics in kids. Hopefully you’ll be aware of the risk to pregant mothers with this infection.

There are however other complications that you need to know about that just might appear in your ED or in your FCEM

Arthralgia/arthritis

• keep parvovirus in your differential for someone presenting with an acute poly arthritis, especially if there’s a recent flu like illness in the back ground
• usually symmetric and in the small joints (something that might make you think rheumatoid but you probably shouldn’t head that direction until symptoms have been present for more than 6 weeks)
• most will have a rash but in adults don’t expect the classic slapped cheek
• should resolve within 3 weeks and there shouldn’t be any joint destruction

Transient Aplastic crisis

• typically someone with some kind of haematologic problems eg sickle or iron def anaemia
• the scenario you should think of this is when you get the FBC back and there an unexpected anaemia
• usually it’s only red cells involved. If checked reticulocytes should be low

References:

• UpToDate
• Rosen’s 8th Chapter 116

[Featured image CC license, via Wikipedia]