Ferreira Noely Evangelista, da Costa Antonio C, Kallas Esper G, Silveira Cassia G T, de Oliveira Ana Carolina S, Honorato Layla, Paião Heuder G O, Lima Silvia H, de M Vasconcelos Dewton, Côrtes Marina F, Costa Silvia F, Mendoza Tania R T, Gomes Hélio R, Witkin Steven S, Mendes-Correa Maria C
Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
Curr Issues Mol Biol. 2023 Aug 22;45(9):6958-6966. doi: 10.3390/cimb45090439.
Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymptomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are common to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl admitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admission and discontinued after negative laboratory results were obtained. Nine days after symptoms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations and emphasizes that its possible involvement might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.
细小病毒B19感染与广泛的临床表现相关，从无症状感染到严重的神经系统疾病。其主要临床症状，发热和皮疹，是多种病毒共有的，并且通常无法进行检测B19的实验室检查。因此，B19对公共卫生的影响仍不清楚。我们报告了一名38天大的女孩的病例，她被送往巴西圣保罗临床医院，初步诊断为细菌性脑膜炎、癫痫和急性脑积水。入院后抗生素治疗维持了一周，在实验室检查结果为阴性后停药。症状出现九天后，一份脑脊液（CSF）样本显示持续性细胞增多。随后通过宏基因组下一代测序方法在她的脑脊液中鉴定出完整的B19基因组。本报告强调了B19可能参与急性神经症状的发生，并强调在病因不明或不确定的临床情况下，使用宏基因组技术检测病毒病原体可能会更好地揭示其可能的参与情况。
