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Volume 31, Number 8—August 2025

Dispatch

Neurologic Manifestations Associated with Parvovirus B19 Epidemic, Madrid, Spain, 2024

Cristina VeintimillaComments to Author , Pilar Catalán, Agustín Estévez, Roberto Alonso, Maricela Valerio, and Patricia Muñoz
Author affiliation: Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain (C. Veintimilla, P. Catalán, A. Estévez, R. Alonso, M. Valerio, P. Muñoz); Instituto de Investigación Sanitaria Gregorio Marañón, Madrid (C. Veintimilla, P. Catalán, A. Estévez, R. Alonso, M. Valerio, P. Muñoz); School of Medicine, Universidad Complutense de Madrid, Madrid (P. Catalán, R. Alonso, M. Valerio, P. Muñoz); Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid (P. Muñoz)

Main Article

Table

Clinical and epidemiologic characteristics of parvovirus B19 in CSF of case-patients with neurologic manifestations associated with parvovirus B19 epidemic, Madrid, Spain, 2014–2024*

Characteristic Case-patient no.
1 2 3 4 5 6 7 8
Age, y/sex
 17/M
 77/M
 10/F
 42/F
 65/M
 46/M
 78/M
 <1/M†
Diagnosis date
 2014 Jan
2022 Aug
2024 May
2024 May
2024 May
 2024 May
 2024 Jun
2024 Aug 2
Location
 IP
 IP
 IP
 IP
 IP
 OP
 IP
 IP
Relevant medical history
 Acute lymphocytic leukemia
 Hepatic steatosis
 Migraine with aura
 Schizophrenia, migraine
 Prostate cancer
 BPDCN
 COPD, hypertension
 Premature birth
Neurologic symptoms
 Mental status change
 Mental status change, encephalopathy and delirium
 Stroke
 Visual hallucinations
 Memory loss episodes
 Persistent headache
 Encephalopathy, mental status change
 Poorly responsive and central seizures
Other symptoms 
and signs
 Fever
 None
 Fever
 Fever and arthralgias
 None
 None
 Fever
 None
Initial IgM/IgG, serum
 −/−
 NA/−
 −/−‡
 +/+
 −/NA
 −/+
 +/NA
 NA/NA
Hematologic findings
 Anemia (8.6 g/dL), TCP (10,000/µL)
 Anemia (7.7 g/dL), TCP (42,000/µL)
 UN
 Lymphopenia (300 cells/µL)
 Anemia (8.6 g/dL)
 UN
 TCP (69,000/µL), leukopenia (2,600 cells/µL)
 Anemia (9.5 g/dL), TCP (67,000/µL)
CSF
Leukocytes
 0
 0
 0
 0
 70
 0
 0
 NA; RBCs in CSF
Protein level, mg/dL
87
 42
 40
 39
 129
 36
 49
 136
Viral DNA
 Positive
 Positive
 Positive
 Positive
 Positive
 Positive
 Positive
 Positive
Plasma viral DNA
 Positive
 Positive
 Positive
 Positive
 Negative
 Negative
 Positive
 Positive
Treatment IVIg IVIg 2 doses acyclovir 1 dose acyclovir No IVIg 10 d
acyclovir		 No

*BPDCN, blastic plasmacytoid dendritic cell neoplasm; COPD, chronic obstructive pulmonary disease; CSF, cerebrospinal fluid; IP, inpatient; IVIg, intravenous immunoglobulin; NA, not available; OP, outpatient; RBCs, red blood cells (erythrocytes); TCP, thrombocytopenia. †Three-day-old infant. ‡Initial parvovirus B19 IgM and IgG were negative but seroconverted to 3 weeks later. §Upper normal limit 30 mg/dL.

Main Article

Page created: July 02, 2025
Page updated: July 22, 2025
Page reviewed: July 22, 2025
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