Meningoencephalitis associated with Parvovirus B19 Infection in an Immunocompetent Patient

Dae-Seung Lee; Jin-Hyung Lee; So-Young Huh; Min Jeong Kim; Meyung-Kug Kim; Bong-Goo Yoo

doi:10.7180/kmj.2015.30.2.181

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Lee, Lee, Huh, Kim, Kim, and Yoo: Meningoencephalitis associated with Parvovirus B19 Infection in an Immunocompetent Patient

Case Report

Kosin Medical Journal 2015;30(2):181-185.

Published online: 20 January 2015

DOI: https://doi.org/10.7180/kmj.2015.30.2.181

Meningoencephalitis associated with Parvovirus B19 Infection in an Immunocompetent Patient

Dae-Seung Lee, Jin-Hyung Lee, So-Young Huh, Min Jeong Kim, Meyung-Kug Kim, Bong-Goo Yoo

Department of Neurology, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Bong-Goo Yoo, MD, PhD Department of Neurology, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea TEL: +82-51-990-6364 FAX: +82-51-990-3077 E-mail: ybgne@kosinmed.or.kr

Received 30 November 201530 November 2015 Accepted 30 November 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Parvovirus B19 (PVB19) infection is a rare cause of meningoencephalitis. A 53-year-old previously healthy woman presented with fever, headache, and multiple erythema on the both legs. Cerebrospinal fluid study revealed pleocytosis and elevated opening pressure and protein level. Brain MRI showed multiple, asymmetric, hyperintensity in the brain stem, basal ganglia, white matter, and gray matter. Anti-B19 IgM antibody and PCR for PVB19 were positive in serum. Clinician should consider PVB19 infection in any case of acute febrile illness with erythema and meningoencephalitis

Keywords: Meningoencephalitis, MRI, Parvovirus B19

References

1. Koch WC. Fifth (human parvovirus) and sixth (herpesvirus 6) diseases. Curr Opin Infect Dis. 2001; 14:343–56.

2. Douvoyiannis M, Litman N, Goldman DL. Neurologic manifestations associated with parvovirus B19 infection. Clin Infect Dis. 2009; 48:1713–23.

3. Barah F, Vallely PJ, Cleator GM, Kerr JR. Neurological manifestations of human parvovirus B19 infection. Rev Med Virol. 2003; 13:185–99.

4. Barah F, Vallely PJ, Chiswick ML, Cleator GM, Kerr JR. Association of human parvovirus B19 infection with acute meningoencephalitis. Lancet. 2001; 358:729–30.

5. Bonvicini F, Marinacci G, Pajno MC, Gallinella G, Musiani M, Zerbini M. Meningoencephalitis with persistent parvovirus B19 infection in an apparently healthy woman. Clin Infect Dis. 2008; 47:385–7.

6. Tonnellier M, Bessereau J, Carbonnell N, Guidet B, Méritet JF, Kerr JR, et al. A possible parvovirus B19 encephalitis in an immunocompetent adult patient. J Clin Virol. 2007; 38:186–7.

7. Broliden K, Tolfvenstam T, Norbeck O. Clinical aspects of parvovirus B19 infection. J Intern Med. 2006; 260:285–304.

8. Young NS, Brown KE. Parvovirus B19. N Engl J Med. 2004; 350:586–97.

9. Kerr JR, Barah F, Chiswick ML, McDonnell GV, Smith J, Chapman MD, et al. Evidence for the role of demyelination, HLA-DR alleles, and cytokines in the pathogenesis of parvovirus B19 meningoencephalitis and its sequelae. J Neurol Neurosurg Psychiatry. 2002; 73:739–46.

10. Isumi H, Nunoue T, Nishida A, Takashima S. Fetal brain infection with human parvovirus B19. Pediatr Neurol. 1999; 21:661–3.

Fig. 1.

Axial FLAIR images show multiple, diffuse, asymmetric hyperintensities involving pons, midbrain, temporal lobe, bilateral thalami, basal ganglia, deep white matter, and temporal and occipital cortex.

Fig. 2.

Follow-up FLAIR images 6 months later demonstrate normal without any residual lesions.

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