Tissue specimens in viral transport medium
Punch biopsy size
Keep specimen at 4C
Biopsy tissue from specific organs, including fetal tissue in suspected cases of congenital infection and myocardium, endocardium, or pericardium in suspected cases of myocarditis/pericarditis.
Tissue not in viral transport medium
Amplification and detection of conserved region of parvovirus B19 DNA structural protein genes VP1 and VP2 using TaqMan real-time PCR technology. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
Erythema infectiosum (Fifth disease) is the most common manifestation of parvovirus B19 infection. The disease is characterized by a distinctive slapped-cheek" rash that gives the child a flushed look. The rash may also involve the limbs and trunk but can fluctuate in intensity for weeks to months with changes in temperature and exposure to sunlight. Arthralgia and arthritis is common among adults infected with parvovirus B19, particularly women. Polyarthropathy of knees, fingers, and other joints is common. In transient aplastic crisis, the patient has severe anemia characterized by lethargy, pallor, and weakness. Condition occurs as a complication in individuals with chronic hemolytic anemias. Normally lasts 7 to 10 days with complete recovery; however, can be life threatening and blood transfusions may be required to prevent death. Chronic infection resulting in severe anemia has been observed in AIDS patients. Infection during pregnancy can cause fetal hydrops, intrauterine growth retardation, congestive heart failure, and death
If positive, results are reported as parvovirus B19 DNA detected.
Negative or no parvovirus B19 DNA detected
The preferred diagnostic test for Fifth disease (erythema infectiosum) and acute arthritis due to parvovirus B19 is detection of parvovirus B19-specific IgM in a single serum specimen. For patients with transient aplastic crisis, serum or plasma PCR for parvovirus B19 DNA should be performed as a supplement to IgM testing since parvovirus B19-specific IgM antibodies may not be detectable until some days after onset of the crisis. Detection of fetal infection or chronic infection in immunocompromised patients is best accomplished by PCR for detection of parvovirus B19 DNA because a serologic response to B19 infection may not occur in this setting.