%0 Journal Article
%T Seizure and Hepatosplenomegaly¡ªRare Manifestation of Parvovirus B-19: A Case Report and Review of the Literature
%A Yadav Kamlesh
%A Gupta Pallav
%A Murari Manjula
%A Malik Rohan
%J Journal of Tropical Medicine
%D 2011
%I Hindawi Publishing Corporation
%R 10.1155/2011/287914
%X Parvovirus B19 is the etiologic agent of erythema infectiosum (fifth disease), a fever-rash illness occurring in childhood. We present a 10 month old child with high grade fever for 10 days, generalized tonic-clonic seizure, bilateral cervical lymphadenopathy, generalized maculopapular rash, hematemesis and malena. Bone marrow aspiration and liver biopsy were done. EBV serology and parvovirus PCR were also performed. Bone marrow aspiration and biopsy showed giant pro-erythroblast consistent with parvovirus infection. PCR showed amplification of parvovirus genomic sequences. Present case highlights an atypical presentation of Parvovirus B19 infection as fever, rash and hepatosplenomegaly. 1. Introduction Parvovirus B19 is the etiologic agent of erythema infectiosum (fifth disease), a fever/rash illness occurring in childhood. In adults it causes varying degree of aplastic anemia usually in immunocompromised hosts due to organ transplant or immunodeficiency syndromes. Systemic manifestation of infection includes multisystem involvement and viral hemophagocytic syndrome. Hepatitis and encephalitis resulting in hepatosplenemegaly and seizure may also be caused by parvovirus, however incidence is very rare [1]. Very few case reports exist in the literature with a clinical manifestation of fever, rash, hepatosplenomegaly, and seizure as a result of parvovirus infection. Herein we describe a case presenting with fever, rash, hepatosplenomegaly, and seizure due to parvovirus infection. 2. Case Report A 10-month-old child presented with high-grade fever for 10 days followed by three episodes of generalized tonic-clonic seizure. Subsequently patient developed bilateral cervical lymphadenopathy, generalized maculopapular rash, hematemesis, and melena. On examination child was irritable with weight 7.5£¿kg, height 71£¿cm, head circumference 41£¿cm, mild pallor, and healed ulcers in oral cavity. Liver span was 4.5£¿cm firm with rounded margin, coarse ecotecture on USG, and spleen was palpable 4.0£¿cm below left costal margin. With the previous presentation, differential diagnosis of postviral hemophagocytosis/infiltrative disorders was kept. On investigation total leukocyte count was high with lymphocytosis, and peripheral smear showed activated lymphocytes. Fibrinogen was low, ferritin was high, and triglyceride was raised (Table 1). Bone marrow aspiration and liver biopsy were done. EBV serology and parvovirus PCR were also performed. Bone marrow aspiration and biopsy showed giant proerythroblast consistent with parvovirus infection (Figures 1 and 2). CSF culture was
%U http://www.hindawi.com/journals/jtm/2011/287914/