0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:18
1142 Parvovirus B19 Patent Ductus Arteriosus■Aplastic crisis – Parvo B19 is most common cause of aplastic cri-
sis but may need to distinguish from systemic bacterial infections
(Salmonella, Streptococcus pneumoniae)
management
■Supportive
■Transient aplastic crisis – may require transfusion
■Chronic anemia immunodeficient patient – IVIG
■Pregnancy – monitor closely, B19 immune hydrops may require
intrauterine blood transfusion
specific therapy
■No specific antiviral indicated
follow-up
n/a
complications and prognosis
■Chronic infection with anemia: immunodeficient (especially con-
genital immunodeficiency syndromes, leukemia, cancer, HIV, tissue
transplant patients) patients
■Aplastic crisis: in chronic hemolytic anemia* (often present with pal-
lor, weakness, lethargy, anemia. Rash usually absent)
➣(*includes sickle cell anemia/hereditary spherocytosis/thalasse-
mia/G6PD deficiency, PK deficiency)
■congenital infection – fetal hydrops or death – risk of fetal death is
0.6–1.25% based on rate of fetal death after maternal infection (2.5–
5%), rate of susceptibility (50% in women of childbearing age) and
rate of infection after given exposure (50%)
■case reports described: transient hemolytic anemia, meningitis/
encephalitis, HSP, myocarditis and pseudo-appendicitisPATENT DUCTUS ARTERIOSUS
MARIA ANSARI, MD
history & physical
History
■Females: Males 2:1
■Associated with maternal rubella
■Usually an isolated defect, but may coexist with coarctation, VSD,
pulmonic stenosis, aortic stenosis
■Represents 5–10% of adult congenital heart disease