Adult acute respiratory distress syndrome due to human parvovirus B19 infection after cardiac surgery: a case report

BACKGROUND: Infection with human parvovirus B19 (PB19) is very common in pediatric patients. Symptoms and signs depend on the infected patient’s immune and hematopoietic status and can range from an asymptomatic condition to life-threatening disease. CASE PRESENTATION: A 69-year-old man received elective mitral valvular replacement and tricuspid valvuloplasty under cardiopulmonary bypass and suffered acute respiratory distress syndrome on postoperative day 8. Through the detection of positive serum IgM and human PB19-specific nucleic acids in serum and bronchoalveolar lavage fluid via metagenomic next-generation sequencing (mNGS), acute human PB19 infection was confirmed. The patient was ventilated and the pulmonary infiltration was attenuated six days later. CONCLUSION: A combination of serum human PB19 DNA by mNGS and positive serum human PB19 IgM could provide higher diagnostic sensitivity for acute human PB19 infection. The method of mNGS may be a new choice for detecting rare or atypical pathogens in severe complicated pneumonia. The infection of human PB19 was possibly self-limited.