Rawat Rishabh, Kampani Geeta, Saini Kunal, Talapa Ravi
Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi, IND.
Cureus. 2024 Sep 11;16(9):e69181. doi: 10.7759/cureus.69181. eCollection 2024 Sep.
Parvovirus B19, commonly associated with erythema infectiosum in children, can also present with various clinical manifestations in adults, including arthropathy, myocarditis, vasculitis, and neurological complications. This case report describes a 39-year-old male who presented with fever, rash, and polyarthralgia, followed by the sudden onset of left-sided facial weakness and slurred speech. Clinical examination revealed lower motor neuron facial nerve palsy and signs consistent with cutaneous small-vessel vasculitis. Extensive laboratory investigations confirmed the presence of parvovirus B19 DNA, while tests for other common viral infections and autoimmune markers were negative. The patient was treated with oral prednisolone, resulting in significant improvement in his symptoms over the course of one month. This case highlights the rare but important association between parvovirus B19 infection and both neurological and dermatological manifestations. It underscores the need for healthcare providers to consider viral etiologies in the differential diagnosis of facial nerve palsy and vasculitis, particularly when presented with concurrent symptoms of systemic infection. Early diagnosis and appropriate management are crucial for improving patient outcomes in such atypical presentations. This report adds to the growing body of literature on the diverse clinical manifestations of parvovirus B19, emphasizing the importance of recognizing and treating these rare complications promptly.
细小病毒B19通常与儿童传染性红斑有关,在成人中也可表现出各种临床表现,包括关节病、心肌炎、血管炎和神经并发症。本病例报告描述了一名39岁男性,他最初出现发热、皮疹和多关节痛,随后突然出现左侧面部无力和言语不清。临床检查发现为下运动神经元性面神经麻痹以及与皮肤小血管血管炎相符的体征。广泛的实验室检查证实存在细小病毒B19 DNA,而其他常见病毒感染和自身免疫标志物的检测均为阴性。该患者接受口服泼尼松龙治疗,一个月内症状有显著改善。本病例突出了细小病毒B19感染与神经和皮肤表现之间罕见但重要的关联。它强调了医疗保健提供者在面神经麻痹和血管炎的鉴别诊断中考虑病毒病因的必要性,特别是当出现全身感染的并发症状时。早期诊断和适当治疗对于改善此类非典型表现患者的预后至关重要。本报告增加了关于细小病毒B19多样临床表现的文献,强调了及时识别和治疗这些罕见并发症的重要性。