Kirchesch H
Universitäts-Hautklinik Köln.
Z Hautkr. 1990 Nov;65(11):1007-10.
Severe chronic anemia, transitory aplastic crisis (TAC), and lethal hydrops fetalis may be due to an infection with parvovirus B19 i.e. the causative agent of erythema infectiosum. 80% of the patients infected with B19 develop clinical symptoms and typically show the picture of erythema infectiosum--as one of our case reports (daughter) is going to illustrate. Part of the cases, however, take a course without the characteristic slapped-face rash; here we frequently find acute arthritis and arthralgia, as well as fever and rubella-like or purpura-like rashes, predominantly on the smaller joints (mother). In immuno-compromised patients, those with hematologic disorders, as well as in pregnancy, the diseases may take a life-threatening course. In the cases without the characteristic rash, the diagnosis has to be proved by the detection of either antibodies against parvovirus B19 or the virus itself; however, the test kits required are not readily available. Since there is no generally accepted treatment of the infection, as yet, the most important measure on the medical side is the prevention of the infection by means of isolation and other procedures. The problem we face here, however, is the fact that the danger of infection is highest during the viremic phase of the disease, when the patient is still asymptomatic.
严重慢性贫血、短暂性再生障碍危象（TAC）和致死性胎儿水肿可能是由B19细小病毒感染所致，即传染性红斑的病原体。80%感染B19的患者会出现临床症状，典型表现为传染性红斑——正如我们的一份病例报告（女儿）即将展示的那样。然而，部分病例并无典型的“巴掌脸”皮疹；在此类病例中，我们经常发现急性关节炎和关节痛，以及发热和风疹样或紫癜样皮疹，主要出现在小关节（母亲）。在免疫功能低下的患者、血液系统疾病患者以及妊娠期，病情可能会发展为危及生命。对于没有典型皮疹的病例，必须通过检测抗B19细小病毒抗体或病毒本身来确诊；然而，所需的检测试剂盒并不容易获得。由于目前尚无普遍认可的针对该感染的治疗方法，因此从医学角度来看，最重要的措施是通过隔离及其他手段预防感染。然而，我们在此面临的问题是，在疾病的病毒血症期，即患者仍无症状时，感染风险最高。
