No specific treatment exists for parvovirus B19 infection. Management is supportive and the infection is usually mild and self-limiting. A nonsteroidal anti-inflammatory agent may be sufficient for associated arthritis; if needed, a low-dose oral corticosteroid can be used without prolonging the viral illness.6 Refer for hematologic consultation any immunocompromised patient with confirmed parvovirus who develops a hematologic complication, which may require intravenous immunoglobulin treatment or, in severe cases, bone marrow transplantation.
Clinical recommendations
Parvovirus B19 is communicable only during the nonspecific prodromal period—the 4 to 21 days of incubation in which the patient seems to have a common cold, with coryza, sore throat, and headache. With the appearance of the “slapped cheek” rash (an immune-mediated, postinfectious sequela), a child with erythema infectiosum is no longer infectious. At this stage, exclusion from school or child care is unnecessary.1
Perform serologic testing to determine immunity for all pregnant women with documented exposure to parvovirus B19.12 Retest women who are initially nonimmune after 3 to 4 weeks. Patients who seroconvert should undergo serial ultrasounds for 10 weeks to evaluate for hydrops fetalis or growth restriction. Repeat testing is unwarranted for those who do not seroconvert. There is no evidence to suggest that seronegative pregnant women should avoid work environments during endemic periods of infection.13
