DOI: 10.12890/2025_005931
A case of parvovirus B19 infection mimicking mumps virus infection in a healthy adult
Authors
hsedogawa@gmail.com
Keywords
Human parvovirus B19, febrile neutropenia, mumps-like submandibular swellingAbstract
Introduction: Human parvovirus B19 infection classically manifests as erythema infectiosum in children, but in adults the clinical spectrum is diverse and often atypical. While transient neutropenia and bone marrow suppression have been reported, mumps-like submandibular swelling is rarely described in immunocompetent adults.
Case description: We report a 38-year-old previously healthy man who presented with high fever and febrile neutropenia. Physical examination revealed pronounced bilateral submandibular swelling without parotid involvement. The patient’s child had had a recent febrile illness, raising suspicion for mumps virus infection; however, serology for mumps antibodies was negative. Empiric therapy with intravenous meropenem was initiated. The patient’s symptoms and neutropenia resolved promptly. Extensive evaluation for infectious and hematologic diseases was negative, but polymerase chain reaction for parvovirus B19 in blood was positive. The clinical course was favourable without complications.
Discussion: This case highlights a rare presentation of acute parvovirus B19 infection in a healthy adult male, characterized by febrile neutropenia and mumps-like bilateral submandibular swelling. Although most adult parvovirus B19 infections present with arthralgia and rash, clinicians should consider parvovirus B19 as a differential diagnosis in adults presenting with unexplained neutropenia and salivary gland swelling, even in the absence of anaemia or typical rash. The possibility of parvovirus B19 should be especially considered when there is a history of contact with children displaying febrile illness. Early recognition may prevent unnecessary broad-spectrum antibiotic use and guide appropriate management.
Conclusion: Parvovirus B19 infection in immunocompetent adults can manifest with atypical features such as febrile neutropenia and submandibular gland swelling resembling mumps. A high index of suspicion and appropriate virological testing are essential for accurate diagnosis and management.
References
- Saeki T, Shibuya M, Sawada H, et al. Human parvovirus B19 infection mimicking systemic lupus erythematosus. Mod Rheumatol 2001;11:308–313. doi: 10.3109/s10165-001-8061-3
- Hübel E, Ladda E, Löffler B, Schumacher K. Manopedale purpura (“glove and sock” syndrome) caused by parvovirus B19 infection. Dtsch Med Wochenschr 1994;119:766–770. doi: 10.1055/s-2008-1058759
- Barlow GD, McKendrick MW. Parvovirus B19 causing leucopenia and neutropenia in a healthy adult. J Infect 2000;40:192–195. doi: 10.1016/s0163-4453(00)80018-3
- Frotscher B, Salignac S, Morlon L, Bonmati C, Jeulin H, Venard V, et al. Neutropenia and/or thrombocytopenia due to acute parvovirus B19 infection. Ann Biol Clin (Paris) 2009;67:343–348. doi: 10.1684/abc.2009.0324
- Sharifi-Mood B, Metanat M, Khalili M. Mumps and severe neutropenia: presentation of two cases and review of the literature. J Med Sci 2006;6:709–712. doi: 10.3923/jms.2006.709.712
- Shehi E, Ghazanfar H, Fortuzi K, Gonzalez E, Zeana C. A rare case of parvovirus B19 infection manifesting as chronic aplastic anemia and neutropenia in a human immunodeficiency virus-infected patient. Cureus 2020;12:e12174. doi: 10.7759/cureus.12174
- de Oliveira Simões F, Goncalves H, Sá R, Fraga Campos B, Domingues RM, Oliveira N, et al. Parvovirus B19-induced pancytopenia: a case report of aplastic crisis. Cureus 2024;16:e76660. doi: 10.7759/cureus.76660
- Honda K, Ishiko O, Tsujimura A, Hino M, Hirai K, Itoh F, et al. Neutropenia accompanying parvovirus B19 infection after gynecologic surgery. Acta Haematol 2000;103:186–190. doi: 10.1159/000041047
- Akin M, Carman KB, Karaturk AH, Ceran O. Mumps-like syndrome owing to parvovirus B19: a brief report. Ann Trop Paediatr 2002;22:57–58. doi: 10.1179/027249302125000166