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パルボウイルスB19感染の診断後のフォロー

参考文献:Long Sarah S, Prober Charles G,Fischer Marc:Principles and Practice of Pediatric Infectious Diseases, 5th EditionElsevier, 2018
出典
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1: 著者提供

ヒトパルボウイルスB19関連感染症

感染する対象別の疾患群
 
出典
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1: Long Sarah S, Prober Charles G,Fischer Marc:Principles and Practice of Pediatric Infectious Diseases, 5th ed., Elsevier, 2018.

伝染性紅斑の四肢の網目状紅斑

四肢に網目状紅斑
出典
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1: 著者提供

胎児水腫

胎児の造血が障害されることにより、貧血および心不全を呈する。
出典
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1: Human parvovirus B19.
著者: Erik D Heegaard, Kevin E Brown
雑誌名: Clin Microbiol Rev. 2002 Jul;15(3):485-505.
Abstract/Text: Parvovirus B19 (B19) was discovered in 1974 and is the only member of the family Parvoviridae known to be pathogenic in humans. Despite the inability to propagate the virus in cell cultures, much has been learned about the pathophysiology of this virus, including the identification of the cellular receptor (P antigen), and the control of the virus by the immune system. B19 is widespread, and manifestations of infection vary with the immunologic and hematologic status of the host. In healthy immunocompetent individuals B19 is the cause of erythema infectiosum and, particularly in adults, acute symmetric polyarthropathy. Due to the tropism of B19 to erythroid progenitor cells, infection in individuals with an underlying hemolytic disorder causes transient aplastic crisis. In the immunocompromised host persistent B19 infection is manifested as pure red cell aplasia and chronic anemia. Likewise, the immature immune response of the fetus may render it susceptible to infection, leading to fetal death in utero, hydrops fetalis, or development of congenital anemia. B19 has also been suggested as the causative agent in a variety of clinical syndromes, but given the common nature, causality is often difficult to infer. Diagnosis is primarily based on detection of specific antibodies by enzyme-linked immunosorbent assay or detection of viral DNA by dot blot hybridization or PCR. Treatment of persistent infection with immunoglobulin reduces the viral load and results in a marked resolution of anemia. Vaccine phase I trials show promising results.
Clin Microbiol Rev. 2002 Jul;15(3):485-505.

伝染性紅斑の頬部紅斑

リンゴのように両頬部が赤くなることからリンゴ病、ほっぺ病などと呼ばれた。
出典
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1: 著者提供

伝染性紅斑 体幹部の紅斑

背中に網目状に白く抜ける紅斑がみえる。
出典
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1: 著者提供

パルボウイルスB19によるaplastic crisisの発症時の症状

米国のニューヨークでaplastic crisisを起こした22人の小児の基礎疾患と臨床症状を検討した研究より、発熱が73%で最も多くみられた症状で、健常児に多い皮疹を認めた児はいなかった。
出典
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1: Clinical presentation of parvovirus B19 infection in children with aplastic crisis.
著者: Richard Kellermayer, Howard Faden, Mauro Grossi
雑誌名: Pediatr Infect Dis J. 2003 Dec;22(12):1100-1. doi: 10.1097/01.inf.0000101783.73240.4a.
Abstract/Text: The records of 22 children with parvovirus B19-induced aplastic crisis were reviewed. The group consisted of 16 children with sickle cell hemoglobinopathies and 6 with hereditary spherocytosis. Children presented to the hospital 0.5 to 8 days (mean, 2.4 days) after the onset of symptoms. The children with sickle-cell disease presented earlier (mean, 1.4 days) than did children with hereditary spherocytosis (mean, 5 days; P = 0.02. Fever was the most common symptom, occurring in 73% of children. Rash did not occur in either group. Reticulocyte counts began to rise 1 week after onset of illness associated with a rise in parvovirus B19-specific IgG antibody. These data suggest that parvovirus B19 infection in children with sickle-cell hemoglobinopathies and heredity spherocytosis differs from infection in normal children.
Pediatr Infect Dis J. 2003 Dec;22(12):1100-1. doi: 10.1097/01.inf.0000...

パルボウイルスB19感染の診断後のフォロー

参考文献:Long Sarah S, Prober Charles G,Fischer Marc:Principles and Practice of Pediatric Infectious Diseases, 5th EditionElsevier, 2018
出典
img
1: 著者提供

ヒトパルボウイルスB19関連感染症

感染する対象別の疾患群
 
出典
img
1: Long Sarah S, Prober Charles G,Fischer Marc:Principles and Practice of Pediatric Infectious Diseases, 5th ed., Elsevier, 2018.