Bozzola Elena, Krzysztofiak Andrzej, Cortis Eisabetta
Ospedale Bambino Gesu, Rome, Italy.
Infez Med. 2010 Sep;18(3):187-90.
Human parvovirus B19 (HPV-B19) is usually a self-limiting infection in immunocompetent children. In this case report, instead, we describe an immunocompotent child with evidence of persistent HPV-B19 infection, arthritis and neurological impairment. He was first admitted to hospital for HPV-B19 infection and sent home in good clinical condition after anti-inflammatory therapy. Eight months later he was re-admitted to hospital for episodes of arthritis and weakness, myalgia, tremors in his legs and hands, and was unable to walk unaided. In both plasma and serum, HPV-B19 DNA, detected by polymerase chain reaction, was still present. For neurological symptoms, he underwent magnetic resonance, which showed increased signal intensity at the spinal roots in the lumbar region, compatible with polyradiculoneuritis. After immunoglobulin therapy he had an excellent response in clinical and radiological terms, suggesting an association between neurological impairment and HPV-B19 infection. Eleven months after the second admission, the patient was still in good clinical condition.
人细小病毒B19(HPV - B19)在免疫功能正常的儿童中通常是一种自限性感染。然而,在本病例报告中,我们描述了一名免疫功能正常的儿童,有持续性HPV - B19感染、关节炎和神经功能损害的证据。他最初因HPV - B19感染入院,经抗炎治疗后临床状况良好出院。八个月后,他因关节炎发作、虚弱、肌痛、腿部和手部震颤再次入院,且无法独立行走。通过聚合酶链反应检测发现,其血浆和血清中仍存在HPV - B19 DNA。针对神经症状,他接受了磁共振检查,结果显示腰椎区域脊髓神经根信号强度增加,符合多发性神经根神经炎。免疫球蛋白治疗后,他在临床和影像学方面均有良好反应,提示神经功能损害与HPV - B19感染之间存在关联。第二次入院十一个月后,患者临床状况仍良好。