Human parvovirus B19 infection in immunocompetent adults: A diagnostic challenge due to its multiple clinical manifestations.

INTRODUCTION

Human parvovirus B19 (PVB19) is associated with diverse clinical manifestations. While acute infection in immunocompetent adults is generally considered mild, recent European outbreaks and an increase in severe cases highlight the need to always keep this virus in mind. This study aimed to describe the clinical and epidemiological features of acute PVB19 infection in immunocompetent adults requiring hospital care.

METHODS

We conducted a retrospective study of immunocompetent patients over 14 years old diagnosed with acute PVB19 infection at a Gran Canaria tertiary hospital (2014-2024). Diagnosis was based on detection of viral DNA and/or specific IgM.

RESULTS

Forty-three patients were included (mean age 40.6±13.9 years; 44.2% male). A marked increase in cases was observed in 2024 (51.2% of total). Clinical manifestations included acute polyarthritis (37.2%), cardiac involvement (34.9%), erythema (16.3%), fever of unknown origin, meningitis, and gastrointestinal symptoms. Cardiac involvement, mostly in males, included dilated cardiomyopathy, pericarditis, and myocarditis, and was associated with two deaths. Hematological abnormalities were frequent (up to 80% in cardiac patients). Two additional patients developed systemic inflammatory diseases. Serological testing alone failed to confirm diagnosis in several cases, needing molecular testing of alternative samples.

CONCLUSIONS

Our findings underscore the diverse and potentially severe presentation of PVB19 infection in immunocompetent adults. The high incidence of cardiac involvement and diagnostic challenges highlight the need for enhanced surveillance and clinical awareness. Incorporating PVB19 into differential diagnoses for hospitalized patients with unexplained inflammatory or hematological syndromes may improve timely recognition and management.