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Case Reports
. 2019 Aug;98(35):e16993.
doi: 10.1097/MD.0000000000016993.

Parvovirus B19 Infection Presenting With Neutropenia and Thrombocytopenia: Three Case Reports

Free PMC article
Case Reports

Parvovirus B19 Infection Presenting With Neutropenia and Thrombocytopenia: Three Case Reports

Hyoshim Shin et al. Medicine (Baltimore). .
Free PMC article


Rationale: Parvovirus B19 (PV) infection is usually symptomless and can cause benign, short-lived conditions. Anemia associated with PRCA is the most representative hematologic manifestation, but neutropenia and thrombocytopenia have been rarely reported.

Patient concerns: Three patients were admitted to the hospital with neutropenia and thrombocytopenia. The accompanying symptoms were fever, myalgia, rash, or arthralgia, and all patients were previously healthy.

Diagnosis: Patients were positive for PV PCR and diagnosed with PV infection. Before the diagnosis of PV infection, 2 patients underwent BM study and almost absence of erythroid progenitor cells in BM aspiration were a clue for the PV infection. Other BM findings were hypocellular marrow and a few hemophagocytic histiocytes.

Interventions: Patients received supportive care with follow-up of CBC.

Outcomes: All 3 patients spontaneously recovered from neutropenia and thrombocytopenia within 3 weeks without severe complications.

Lessons: The evaluation of PV infection should be considered in situations where there is neutropenia and thrombocytopenia in healthy individuals even without anemia as a differential diagnosis.

Conflict of interest statement

The authors have no conflicts of interests to disclose.


Figure 1
Figure 1
Schematic diagram of patients who underwent Parvovirus B19 PCR during the study period. The year that the Parvovirus B19 infection occurred is stated in parentheses. HIV = human immunodeficiency virus, HS = hereditary spherocytosis.
Figure 2
Figure 2
Bone marrow (BM) findings of Case 1. BM-aspiration smear showed (A) severe hypocellular particles, (B) a few pronormoblasts (arrow), and (C) hemophagocytic histiocytes (Wright–Giemsa stain, × 100, × 400, and × 400, respectively). (D) BM biopsy showed 10% of cellularity (Hematoxylin-eosin stain, × 100).
Figure 3
Figure 3
WBC, Hb, platelet, ANC, and reticulocyte changes in 3 patients with Parvovirus B19-associated neutropenia and thrombocytopenia during the follow-up period. ANC = absolute neutrophil counts, Hb = hemoglobin, WBC = white blood cells.

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