Which physical findings suggest parvovirus B19 (B19V) infection?

Updated: Oct 11, 2019
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Russell W Steele, MD  more...
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Parvovirus B19 infection may be indistinguishable from other viral illnesses in the absence of the classic exanthem.

  • Children are often febrile, but their appearance is nontoxic and the prodrome is nonspecific.

  • Patients with aplastic crisis have pallor and tachycardia secondary to anemia. Children with aplastic crisis usually do not have a rash. [9] The absence of rash may result from prolonged viremia and lack of anti–parvovirus B19 IgM. Another hypothesis is that patients in aplastic crisis often receive blood transfusions, and any rash may be attributed to a transfusion reaction.

  • A friction rub may be audible if pericarditis is present. Benign flow murmurs are common in anemic children with tachycardia. Patients with myocarditis or severe anemia may present with physical findings of heart failure.

  • The small joints of the hands, feet, elbows, and knees may exhibit signs of arthritis.

  • Painful pruritic papules and purpura may be present on the hands and feet as part of PPGSS.

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