{"id":8585,"date":"2023-03-17T18:59:44","date_gmt":"2023-03-17T15:59:44","guid":{"rendered":"https:\/\/gfmg.ua\/new\/?p=8585"},"modified":"2023-03-23T15:28:05","modified_gmt":"2023-03-23T12:28:05","slug":"pb19","status":"publish","type":"post","link":"https:\/\/gfmg.ua\/en\/pb19\/","title":{"rendered":"Sepsis-like state in newborns due to parvovirus infection"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"8585\" class=\"elementor elementor-8585\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-01e816f elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"01e816f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 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elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"a94656b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-403e4a1\" data-id=\"403e4a1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f34e843 elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"f34e843\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">ARTICLE<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e02bb05 elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading\" data-id=\"e02bb05\" data-element_type=\"widget\" data-widget_type=\"theme-post-title.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\"><a href=\"\">Sepsis-like state in newborns due to parvovirus infection<\/a><\/h1>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-f4f7a9c elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"f4f7a9c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-5483c28\" data-id=\"5483c28\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-09bfbfc elementor-widget elementor-widget-heading\" data-id=\"09bfbfc\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Parvovirus B19 (PB19) is an important human pathogen that results in a wide spectrum of clinical outcomes, from mild, self-limiting erythema infectiosum in immunocompetent children and arthralgia in adults to lethal cytopenia in immunocompromised patients and intrauterine fetal death. However, there have been few reports of PB19 infection in neonates or young infants (aged 28\u201390 days), and no previous reports contained descriptions of PB19 infection as a cause of sepsislike syndrome in this age group. We report a case of sepsislike syndrome caused by PB19 infection in a 56-day-old infant whose mother had polyarthralgia at the time of his admission. PB19 infection was diagnosed on the basis of positive polymerase chain reaction results for PB19 DNA in the serum and cerebrospinal fluid. Positive immunoglobulin M and negative immunoglobulin G for PB19 suggested acute infection. He was admitted to the ICU because of poor peripheral circulation, but fully recovered without antibiotic administration. After excluding other possible pathogens, PB19 should be suspected as a cause of sepsislike syndrome in young infants, especially those who have close contact with PB19-infected individuals.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-c0a1f2e elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"c0a1f2e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-aaffacc\" data-id=\"aaffacc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-72767c3 elementor-widget elementor-widget-heading\" data-id=\"72767c3\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Abbreviations:\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-baa23e7 elementor-widget elementor-widget-html\" data-id=\"baa23e7\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<div>\n    <ul class=\"circle_mark-list list\">\n        <li>CSF \u2014 cerebrospinal fluid<\/li>\n        <li>IgG \u2014 immunoglobulin G<\/li>\n        <li>IgM \u2014 immunoglobulin M<\/li>\n        <li>PB19 \u2014 parvovirus B19<\/li>\n        <li>PCR \u2014 polymerase chain reaction<\/li>\n        <li>SIRS \u2014 systemic inflammatory response syndrome\n<\/li>\n    <\/ul>\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aa0ee70 elementor-widget elementor-widget-heading\" data-id=\"aa0ee70\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Parvovirus B19 (PB19) infection is common in childhood, but its clinical manifestations vary considerably in relation to patient age and immunologic status. PB19 infection typically presents as erythema infectiosum in healthy, immunocompetent school-aged children. <\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-4cf41f5\" data-id=\"4cf41f5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8fa458a elementor-widget elementor-widget-image\" data-id=\"8fa458a\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"560\" height=\"340\" src=\"https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/pb19.jpg\" class=\"attachment-large size-large wp-image-8577\" alt=\"\" srcset=\"https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/pb19.jpg 560w, https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/pb19-64x39.jpg 64w, https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/pb19-300x182.jpg 300w\" sizes=\"(max-width: 560px) 100vw, 560px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-8d9c0a9 elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"8d9c0a9\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-50315ca\" data-id=\"50315ca\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b42317f elementor-widget elementor-widget-heading\" data-id=\"b42317f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Arthralgia is the most common manifestation in adults, particularly in women. PB19 can cause fetal hydrops when mothers develop intrauterine infections. Less common manifestations of PB19 infection in neonates and young infants (aged 28\u201390 days) include meningitis, hepatitis, leukoerythroblastosis, transient myeloproliferation, encephalitis, and hemophagocytic lymphohistiocytosis. However, PB19 infection in this population is rare, and no researchers of previous reports described PB19 infection as a cause of sepsislike syndrome in neonates or young infants. Herein, we report a case of sepsislike syndrome caused by PB19 infection in a young infant.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a8c64ee elementor-widget elementor-widget-heading\" data-id=\"a8c64ee\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Case Presentation\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6e01318 elementor-widget elementor-widget-heading\" data-id=\"6e01318\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">A term 56-day-old boy with a birth weight of 3072 g was admitted to our hospital in January 2016 because of high fever and poor sucking. Perinatal history was unremarkable. He had close contact with sick family members who had clinical symptoms of PB19 infections, namely a 12-year-old cousin and 8-year-old cousin with erythema infectiosum 10 and 6 days before our patient\u2019s admission, respectively. In addition, his mother reported systemic joint pain, a sign of PB19 infection, on the day of his admission. However, they were not tested for PB19-specific antibodies or viral DNA by immunoassay or quantitative polymerase chain reaction (PCR) assay.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f87751 elementor-widget elementor-widget-heading\" data-id=\"1f87751\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">In the emergency department, his vital signs were as follows: body temperature, 39.0\u00b0C; pulse rate, 210 beats per minute; blood pressure, 95\/45 mm\u2009Hg; and respiratory rate, 45 breaths per minute. Peripheral oxygen saturation was 97% in room air. Physical examination revealed significant abdominal distension. Capillary refilling time was prolonged (up to 5 seconds), and his extremities were cold. He had no bulging anterior fontanelle, rash, petechiae, vesicular lesions, hepatosplenomegaly, or abnormal neurologic signs.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-00ec3d7 elementor-widget elementor-widget-heading\" data-id=\"00ec3d7\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Laboratory findings on admission were a white blood cell count of 3.1 \u00d7 109\/L (normal range: 6.0\u201314.0 \u00d7 109\/L), hemoglobin of 97 g\/L (normal range: 98\u2013116 g\/L), mean corpuscular volume of 88 fL (normal range: 72\u201388 fL), reticulocyte count of 3.0% (normal range: 0.1%\u20132.9%), and a platelet count of 218 \u00d7 109\/L (normal range: 84\u2013478 \u00d7 109\/L). A blood smear revealed no evidence of atypical lymphocytes or abnormal red blood cell morphology. Biochemistry testing revealed an aspartate aminotransferase level of 57 U\/L (normal range: 22\u201363 U\/L), an alanine aminotransferase level of 38 U\/L (normal range: 12\u201345 U\/L), lactate dehydrogenase of 237 U\/L (normal range: 170\u2013580 U\/L), total bilirubin level of 0.94 mg\/dL (normal range: &lt;1.0 mg\/dL), and a C-reactive protein level of 21.9 nmol\/L (normal range: 7.6\u2013150.5 nmol\/L). No abnormal findings were observed in cerebrospinal fluid (CSF) or urine.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7949d89 elementor-widget elementor-widget-heading\" data-id=\"7949d89\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The patient did not present with any obvious source of fever on admission. He was critically ill with poor circulation and was admitted to an ICU. Bacterial infection was excluded on the basis of negative results for blood, urine, and CSF cultures. Real-time reverse transcription PCR was used to test serum and CSF samples for herpes simplex virus, enteroviruses, human parechoviruses, and adenovirus, but all tests yielded negative results.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6b0fade elementor-widget elementor-widget-heading\" data-id=\"6b0fade\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">As stated above, the boy had close contact with family members with erythema infectiosum. His mother developed rash on her extremities a few days after she developed arthritis. Because we suspected an outbreak of PB19 among his family members, PB19 was considered as a possible cause of his condition. PB19 DNA was detected in serum and CSF on admission, when he presented with symptoms of sepsislike syndrome, and viral load was high on real-time PCR (1.6 \u00d7 1010 copies\/mL in serum and 1.6 \u00d7 107 copies\/mL in CSF). Sequence analysis of the NS1-VP1 overlapping region (from nt 1765 to nt 2672) of PB19 showed genotype 1A. The presence of positive immunoglobulin M (IgM) results and negative immunoglobulin G (IgG) results indicated acute infection. Ultimately, sepsislike syndrome due to PB19 infection was diagnosed.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3e4a146 elementor-widget elementor-widget-heading\" data-id=\"3e4a146\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">During hospitalization, fever persisted for 2 days but resolved with supportive care. He was well enough to be transferred from the ICU to the pediatric ward on hospital day 2 and was discharged from the hospital on day 6 without sequelae. At the time of discharge, white blood cell count (13.2 \u00d7 109\/L; normal range: 6.0\u201314.0 \u00d7 109\/L) and platelet count (532 \u00d7 109\/L; normal range: 84\u2013478 \u00d7 109\/L) had improved, and hemoglobin level (90 g\/L, normal range: 98\u2013116 g\/L) was close to normal range. No additional measurement of viral load was performed during his hospitalization. Findings of a 2-month follow-up examination were all normal.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-014f60b elementor-widget elementor-widget-heading\" data-id=\"014f60b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Written informed consent was obtained from his parents, and they were informed that the case would be submitted for publication as a case report.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4965594 elementor-widget elementor-widget-heading\" data-id=\"4965594\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Discussion<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2e5959a elementor-widget elementor-widget-heading\" data-id=\"2e5959a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">This is the first case report of a young infant (aged 28\u201390 days) with a sepsislike illness caused by PB19. This age group is susceptible to numerous pathogens; thus, when bacterial infection is ruled out, viral etiologies should be considered, including herpes simplex virus, enterovirus, human parechoviruses, and adenovirus. We diagnosed PB19 infection after real-time PCR detection of PB19 in serum and CSF samples and exclusion of other possible pathogens.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-af9e055 elementor-widget elementor-widget-heading\" data-id=\"af9e055\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">PB19 DNA viral load in serum was extremely high (&gt;1.0 \u00d7 1010 copies\/mL) in our patient. Researchers of a previous study reported that PB19 DNA viral load in the serum was high (median: 7.63 \u00d7 106 genomes\/mL; range: 4.48 \u00d7 103\u20138.31 \u00d7 106) among patients with acute erythema infectiosum. The researchers of that report also found that PB19 DNA viral load in serum during the acute phase of aplastic crisis in chronic hemolytic anemia was extremely high (range: 1.0 \u00d7 1010\u20131.0 \u00d7 1013). The extremely high viral load in our patient suggests that PB19 infection was the cause of severe sepsislike syndrome. The patient had leukopenia at admission, which suggests the possibility of viral infection, including PB19 infection, as a cause. However, leukopenia was not reported by researchers in previous case studies of young infants (aged 28\u201390 days) with PB19 infection. Therefore, it is uncertain whether leukopenia is a characteristic of PB19 infection in young infants.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e2981c5 elementor-widget elementor-widget-heading\" data-id=\"e2981c5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The prevalence of antibodies against PB19 in pregnant women was reported to be 55.4% in Japan, which is similar to prevalences reported in other countries (30%\u201350%), including the Netherlands, Denmark, and the United States. Therefore, approximately half of neonates and young infants are at risk for primary PB19 infection in Japan. However, sepsislike syndrome in young infants has not been reported. A possible explanation for the lack of such reports is that young infants with PB19 infection might not present with rash, which is the most common sign of PB19 infection in children. A literature search revealed only 7 cases of PB19 infection confirmed by positive anti-PB19 IgM and\/or PB19 DNA by PCR of serum or CSF in young infants (Table 1). The clinical presentations included fever, poor feeding, and vomiting; rash was observed in only 1 patient. Although the number of reported cases is small, existing data suggest that PB19 infection can present without rash in young infants. Therefore, many pediatricians might not consider PB19 as the pathogen responsible for sepsislike syndrome presenting in a young infant. A second reason for the lack of previous reports is that, for viral diagnosis of sepsis in neonates and young infants, we usually test for herpes viruses, enteroviruses, and parechoviruses, but not for PB19.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4690b35 elementor-widget elementor-widget-heading\" data-id=\"4690b35\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">A review of the clinical records for 11 infants aged 3 to 11 months who were confirmed to be infected with PB19 by positive IgM and\/or PB19 DNA revealed that no patient had presented with sepsis or sepsislike syndrome. One patient with dilated cardiomyopathy caused by PB19 met the definition of systemic inflammatory response syndrome (SIRS). He had a respiratory rate of 56 breaths per minute and a temperature of 39\u00b0C, and sepsis was thus diagnosed. Four cases did not meet the definition of SIRS, and the reports of the remaining 6 cases had no clinical information on SIRS diagnosis. Therefore, existing evidence is insufficient for determining how often sepsis or sepsislike syndrome develops in infants. A previous report showed that \u223c55% of pathogens responsible for infantile sepsis could not be identified even after thorough investigation. PB19 might be a possible pathogen in such cases. In addition, we suspected that PB19 might be the pathogen responsible for sepsislike syndrome in the present patient because he had close contact with family members who had developed erythema infectiosum. Obtaining a history of sick contacts can be helpful for identifying the pathogen in cases without an apparent source.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-959ed1a elementor-widget elementor-widget-heading\" data-id=\"959ed1a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Conclusions<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eb0cdb1 elementor-widget elementor-widget-heading\" data-id=\"eb0cdb1\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">We reported a case of sepsislike syndrome caused by PB19 infection in a young infant. After excluding other possible pathogens, PB19 should be considered as a cause of sepsislike syndrome in this age group, especially when infants have close contact with PB19-infected individuals. Serological testing for PB19 (IgM and IgG antibodies) should be the first assessment. If serological testing cannot exclude PB19 infection, PCR testing for PB19 should be performed in suspected cases. Obtaining a history of sick contacts was also essential in identifying PB19 as the cause of sepsislike syndrome in our patient.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-4d97d26 elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"4d97d26\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-43cbf9c\" data-id=\"43cbf9c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-600534d elementor-align-right btn_ico 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mild, self-limiting erythema infectiosum in immunocompetent children and arthralgia in adults to lethal cytopenia in immunocompromised patients and intrauterine fetal death. <\/p>\n","protected":false},"author":2,"featured_media":8579,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_canvas","format":"standard","meta":{"footnotes":""},"categories":[58],"tags":[],"class_list":["post-8585","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Sepsis-like state in newborns due to parvovirus infection - Geolik Farm Marketing Group<\/title>\n<meta name=\"description\" content=\"Parvovirus B19 (PB19) is an important human pathogen that results in a wide spectrum of clinical outcomes, from mild, self-limiting erythema infectiosum in immunocompetent children and arthralgia in 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