Severe Outcomes From Suspected Human Parvovirus B19 Infection in Immunocompetent Children: The Need for Timely Recognition

Abstract

We reported a cluster of 13 previously healthy children who, over a short time frame, received care at a Level III Pediatric Hospital following emergency department (ED) presentations with severe outcomes from suspected human Parvovirus B19 (PVB19) infection, and the presence of PVB19 viremia at presentation. Among these patients, we identified seven cases of myocarditis, one case of acute anterior myocardial infarction due to coronary aneurysms secondary to Kawasaki disease, one case of severe anemia with pancytopenia, two cases of encephalitis, one case of septic shock with meningitis, and one case of septic shock with pancreatitis. Four children required ECMO treatment. One patient succumbed to cardiac shock, while two patients were assisted by the Berlin Heart Support System and remain on the transplant list. After discharge, all patients required ongoing medical assistance, including follow-up care or therapy. This report underscores the importance of prioritizing proactive surveillance by health professionals, focusing not only on monitoring emerging pathogens but also on those that may reemerge with increased aggressiveness in the epidemiological landscape. Additionally, it highlights the need to reassess the risk of severe PVB19 infections in healthy populations.

Keywords: children; encephalitis; human parvovirus B19; myocarditis; pancytopenia; septic shock; severe outcome.