Seizure and hepatosplenomegaly-rare manifestation of parvovirus B-19: a case report and review of the literature

Abstract

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.

Figure 1

Bone marrow aspiration showing giant proerythroblast with prominent nucleoli and cytoplasmic blebs. Myeloid cells were relatively increased.

Figure 2

Bone marrow biopsy showing giant proerythroblast, nuclear clearing with eosinophilic intranuclear inclusion and peripheral condensation of chromatin. Late erythroid precursors are reduced, and myeloid cells are increased.