Atypical rashes in adult human Parvovirus B19 infection; atypical is typical

The childhood illness erythema infectiosum (EI) is caused by Parvovirus (PV) B19 with a slapped cheek-like rash and sometimes a lace-like rash on the extremities but cutaneous manifestions in infection in the adult can be atypical. A healthy 38-year-old male office worker and a 32-year-old non-pregnant female kindergarten teacher presented with fever (former; 37.2 C for 3 days, latter 38.1 C for 4 days) following a skin rash persisting several days at different times. Both had a non-pruritic rash (Figs. 1 and 2) on the extremities and a painful postauricular lymphadenopathy. PV B19 infection was confirmed in both by a positive enzyme-linked immunosorbent assay (ELISA) result for serum PV B19-specific IgM. Neither had a typical facial rash nor painful joints. Although the man had no history of exposure to PV B19 infection, the woman was exposed to kindergarteners who with PV B19 infection. In Tokyo, in 2000, 1482 cases overall and 34 individuals aged >15 were reported for PV B19 infection. In 2015, 9076 cases were reported during the first 42 weeks; 174 (1.9%) of these were aged >15. A recent study in Japan showed a seropositive rate of 54.3% among blood donors, and 54 out of 2374 pregnant women developed PV B19 infection [1]. Among sixty-nine pregnant woman who were infected with PV B19 infection, 35 (50.7%) were elected to terminate the pregnancy, 14 were stillborn and 3 had