Parvovirus B19 Infection: A Vasculitis Masquerade in an Elderly Patient

Patient: Male, 78-year-old Final Diagnosis: Human parvovirus B19 infection Symptoms: Fever • edema • skin rash Clinical Procedure: None Specialty: Immunology • Infectious Diseases • General and Internal Medicine • Microbiology and Virology OBJECTIVE: Unusual clinical course BACKGROUND: The profound ability of viral infections to convincingly mimic vasculitis, thereby pathologically influencing vessels of any caliber, is undeniably significant. Notably, adult patients with B19V infection frequently experience joint pain and cutaneous eruptions, which are ostensibly immune responses to the infection and necessitate careful differentiation from autoimmunity. Conversely, vasculitis syndromes represent an amalgamation of diseases characterized by vascular inflammation, predominantly classified based on the impacted vessels’ size and location. Although the expedited diagnosis and therapeutic management of vasculitis are paramount, many conditions, including infectious diseases, can potentially masquerade as vasculitis, necessitating rigorous differential diagnosis. CASE REPORT: A 78-year-old male patient presented with fever, bilateral leg edema, skin rash, and foot numbness to the outpatient department. Blood investigations showed elevated inflammatory parameters, and urinalysis showed proteinuria and occult blood presence. We considered SVV, particularly microscopic polyangiitis, which causes acute renal injury, as the provisional diagnosis. Blood investigations, including auto-antibodies and a skin biopsy, were performed. However, his clinical symptoms resolved spontaneously before these investigation results were reported. Subsequently, the patient was diagnosed with B19V infection based on B19V immunoglobulin M antibody positivity. CONCLUSIONS: B19V infection mimics vasculitis. Even in geriatric patients, particularly during B19V infection outbreaks, clinicians should conduct thorough interviews and examinations while contemplating the likelihood of B19V infection as a potential vasculitis mimic.