1
|
Waghmare BB, Kulkarni PV. A rare cause of fever of unknown origin in India. Diagn Microbiol Infect Dis 2025; 112:116845. [PMID: 40233491 DOI: 10.1016/j.diagmicrobio.2025.116845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Revised: 04/07/2025] [Accepted: 04/10/2025] [Indexed: 04/17/2025]
Abstract
In India, tuberculosis, lymphoma and adult onset Still's disease are the commonly reported causes of fever of unknown origin (FUO). We describe a case of an immunocompetent adult male patient who presented with FUO and anemia. He developed lymphadenopathy after 8 days of admission, for which further workup was done. His bone marrow aspirate showed pure red cell hypoplasia, for the evaluation of which, parvovirus-B19 (B19V) antibodies were ordered which came back positive. He was treated with a short course of steroids and on follow-up showed complete resolution of symptoms.
Collapse
Affiliation(s)
- Bhagyashri B Waghmare
- Department of General Medicine, Bharatratna Atalbihari Vajpayee Medical College, Pune, Maharashtra, 411011, India
| | - Prabhanjan V Kulkarni
- Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, Maharashtra, 411018, India.
| |
Collapse
|
2
|
Dey S, Mohanty M, Mamidi P, Naik S, Gupta K, Dwibedi B, Devi S, Mahapatra A, Das RR, Behera B, Bhoi SK, Mishra B. The emergence of parvovirus B19 as a pathogen in acute encephalitis syndrome. J Med Virol 2024; 96:e29914. [PMID: 39248453 DOI: 10.1002/jmv.29914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 08/23/2024] [Accepted: 08/30/2024] [Indexed: 09/10/2024]
Abstract
Despite scarcity of data, in recent years, human parvovirus B19 (PVB19) has been emerging as an important pathogen in acute encephalitis syndrome (AES). But, PVB19 virus is mostly looked for only after the exclusion of other common pathogens implicated in AES. Hence, this study was conducted to correlate clinical, radiological, and sequencing data to establish the crucial role of PVB19 in AES. Cerebrospinal fluid and/or serum samples were collected from AES patients as per WHO criteria and tested by ELISA, real-time PCR and bacterial culture sensitivity for various pathogens. PVB19 positive samples were subjected to sequencing. PVB19 attributed to 5% of total AES cases in the present study with fatalities in two of eight cases. Two isolates of PVB19 belonged to Genotype 1 A whereas one belonged to Genotype 3B. On multivariate analysis of predictive symptoms of PVB19 AES cases, blurring of vision (odds ratio [OR] 20.67; p = 0.001) was found to be significant independent predictor of PVB19 AES. Six of eight patients (two encephalitis specific and four nonspecific) had abnormal radiological findings. Hence, being an emerging viral pathogen, PVB19 should be included in the diagnostic algorithm of AES for prompt diagnosis and definitive management to prevent undesired neurological sequelae.
Collapse
Affiliation(s)
- Sayantika Dey
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Monalisa Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Prabhudutta Mamidi
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Kavita Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Bhagirathi Dwibedi
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Sujata Devi
- Department of General Medicine, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Ashoka Mahapatra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| |
Collapse
|
3
|
Vilmane A, Terentjeva A, Tamosiunas PL, Suna N, Suna I, Petraityte-Burneikiene R, Murovska M, Rasa-Dzelzkaleja S, Nora-Krukle Z. Human Parvoviruses May Affect the Development and Clinical Course of Meningitis and Meningoencephalitis. Brain Sci 2020; 10:brainsci10060339. [PMID: 32503112 PMCID: PMC7349785 DOI: 10.3390/brainsci10060339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022] Open
Abstract
Meningitis and meningoencephalitis are neurological inflammatory diseases, and although routine diagnostics include testing of a wide range of pathogens, still in many cases, no causative agent is detected. Human parvovirus B19 (B19V), human bocaviruses 1–4 (HBoV1–4), and human parvovirus 4 (hPARV4) are members of the Parvoviridae family and are associated with a wide range of clinical manifestations including neurological disorders. The main aim of this study was to determine whether human parvoviruses infection markers are present among patients with meningitis/meningoencephalitis in Latvia as well as to clarify the role of these viruses on the clinical course of the mentioned diseases. Our study revealed HBoV1–4 and B19V genomic sequences in 52.38% and 16.67% of patients, respectively. Furthermore, symptoms such as the presence of a headache and its severity, fatigue, disorientation, and difficulties to concentrate were significantly frequently present in patients with active parvovirus infection in comparison with parvoviruses negative patients, therefore we suggest that HBoV1–4 and B19V infection should be included in the diagnostics to reduce the number of meningitis/meningoencephalitis with unknown/unexplained etiology.
Collapse
Affiliation(s)
- Anda Vilmane
- Institute of Microbiology and Virology, Rīga Stradiņš University, 5 Ratsupites St., LV-1067 Riga, Latvia; (A.T.); (M.M.); (S.R.-D.); (Z.N.-K.)
- Correspondence: ; Tel.: +371-67060838
| | - Anna Terentjeva
- Institute of Microbiology and Virology, Rīga Stradiņš University, 5 Ratsupites St., LV-1067 Riga, Latvia; (A.T.); (M.M.); (S.R.-D.); (Z.N.-K.)
| | - Paulius L. Tamosiunas
- Vilnius University Life Sciences Center Institute of Biotechnology, 7 Sauletekio Al., 10257 Vilnius, Lithuania; (P.L.T.); (R.P.-B.)
| | - Normunds Suna
- Department of Neurology and Neurosurgery, Riga East Clinical University Hospital “Gaiļezers”, 2 Hipokrata St., LV-1038 Riga, Latvia; (N.S.); (I.S.)
| | - Inga Suna
- Department of Neurology and Neurosurgery, Riga East Clinical University Hospital “Gaiļezers”, 2 Hipokrata St., LV-1038 Riga, Latvia; (N.S.); (I.S.)
| | - Rasa Petraityte-Burneikiene
- Vilnius University Life Sciences Center Institute of Biotechnology, 7 Sauletekio Al., 10257 Vilnius, Lithuania; (P.L.T.); (R.P.-B.)
| | - Modra Murovska
- Institute of Microbiology and Virology, Rīga Stradiņš University, 5 Ratsupites St., LV-1067 Riga, Latvia; (A.T.); (M.M.); (S.R.-D.); (Z.N.-K.)
| | - Santa Rasa-Dzelzkaleja
- Institute of Microbiology and Virology, Rīga Stradiņš University, 5 Ratsupites St., LV-1067 Riga, Latvia; (A.T.); (M.M.); (S.R.-D.); (Z.N.-K.)
| | - Zaiga Nora-Krukle
- Institute of Microbiology and Virology, Rīga Stradiņš University, 5 Ratsupites St., LV-1067 Riga, Latvia; (A.T.); (M.M.); (S.R.-D.); (Z.N.-K.)
| |
Collapse
|