Viral Arthritis - Parvovirus B19 arthritis

Discovered in 1975, parvovirus B19 is a small virus, cleaved DNAto replicate in dividing cells and a remarkable tropism for humanerythropoietic cells. He is responsible for 12% of cases of sudden onset of arthritis, polyarticular, especially adults with frequentexposure in children: teachers, pediatric nurses. Erythemainfectious episodes occur in winter and spring, but the conditioncan be observed in summer.

The clinical picture in children include:
-70% of cases are asymptomatic
flu-symptoms of headache, fever, pharyngitis, cough, anorexia,vomiting, diarrhea, arthralgia
-red erythema characterized as "slapped cheeks"
-articular symptoms are rare.

The clinical presentation in adults:
-erythema is rarely
joint symptoms, occurring in 60% of patients, arthralgia is morecommon than frank arthritis
-arthralgia is usually self-limited, symmetrical and affects theperipheral small joints
-morning stiffness and joint swelling: ankles, fingers, wrists.
Infection with parvovirus B19 is also responsible for several otherdiseases: infectious erythema, transient aplastic crisis (particularly in patients with thalassemia, sicelmie, anemia induced by HIV)infected mothers and fetal hydrops.

Rare pathological conditions:
-Henoch purpura-Scholein
-thrombotic thrombocytopenic purpura
polyarteritis nodosum-
, Wegener's granulomatosis.

Route of transmission:
-by respiratory secretions
blood-products, especially clotting factors
-vertical transmission from mother to fetus, mortality is high in the first or second semester.
Hepatitis A virus infection: 10-14% of cases include viral arthritis.Arthralgia and rash appears in the acute phase. Transmission isfecal-oral route.