Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.
Volume 31, Number 8—August 2025
Dispatch
Neurologic Manifestations Associated with Parvovirus B19 Epidemic, Madrid, Spain, 2024
, Pilar Catalán, Agustín Estévez, Roberto Alonso, Maricela Valerio, and Patricia Muñoz
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.