article · International Journal of Infectious Diseases
Parvovirus infection presents with distinct clinical features and severity levels between adult and paediatric patients. While fever affects most individuals in both cohorts, children experience significantly higher rates of conjunctivitis and nasal congestion. Rash patterns also vary substantially by age. Children more frequently exhibit upper extremity rashes, spot or petechial rashes, and classic slapped cheek presentations, whereas adults are more prone to maculopapular, haemorrhagic, or genital rashes. Adults face a more severe clinical course overall, evidenced by higher rates of thrombocytopenia, elevated C-reactive protein levels, and bacterial complications, which occur in over forty percent of adult cases compared to just fourteen percent in children. Recognising these divergent clinical manifestations is vital for improving differential diagnosis and ensuring age-appropriate treatment strategies.
Parvovirus infections are increasingly recognised following the COVID-19 pandemic and can mimic other diseases. Understanding that symptoms differ significantly between children and adults helps healthcare practitioners avoid misdiagnosis, assess the higher risk of bacterial complications in adult patients, and tailor clinical management according to age.
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5 days [Q1-Q3: 4-7] for adults and 4 days [Q1-Q3: 3-5] for children (p < 0.001).Increased body temperature was recorded in 80% of adults and 90% of children.Conjunctivitis was present in 81.6% of children and 18.8% of adults (p < 0.001), and nasal congestion was present in 81.6% of children and 20.3% of adults (p < 0.001).Skin rash was absent in 6.1% of children and 17.4% of adults.Maculopapular rash occurred in 57.1% of children and 66.7% of adults, while hemorrhagic rash occurred in 8.2% and 15.9%, respectively.Spot and petechial rashes were observed only in children at 24.5% and 4.1%, respectively (p < 0.001).Trunk rash was observed in 67.3% of children and 47.8% of adults, while lower extremity rash affected 69.4% of children and 65.2% of adults.Upper extremity rash was typical for 75.5% of children and 45.6% of adults.Facial rash was present in 42.9% of children and 35.3% of adults.Palm rash was observed in 14.3% of children and 26.1% of adults; rash on low extremities was observed in 14.3% of children and 14.5% of adults.Genital rash was absent in all children but observed in 7.2% of adults.Slapped cheek rash was present in 36.7% of children but absent in adults (p < 0.001).Thrombocytopenia was observed in 10.2% of children and 42.0% of adults (p < 0.001).Elevated CRP levels were seen in 83% of adults [Q1-QQ3: 8.00; -62.90] and 41.1% of children [Q1-QQ3: 2.00-9.30].Bacterial complications occurred in 43.5% of adults and 14.3% of children.Discussion: In adults, the disease is more severe compared to children.Significant differences in clinical manifestations of parvovirus infection between children and adults emphasize the need for an individualized approach to diagnosis and treatment.Conclusions: Following the COVID-19 pandemic, parvovirus infection is increasingly being recognized in both adults and children, presenting with diverse clinical manifestations.These differences should be considered in differential diagnosis with diseases sharing similar clinical symptoms.Physicians should account for age differences when diagnosing and treating the condition.
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DOI: 10.1016/j.ijid.2024.107517
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