Unusual Localisation of Chronic Arthropathy in Lumbar Facet Joints after Parvovirus B19 Infection

Abstract

Human parvovirus B19 infection may be responsible for acute and chronic arthropathy. We present the case of a woman, who developed a severe chronic parvovirus B19 infection with persistence of DNA parvovirus B19, which was detected in the serum by polymerase chain reaction (PCR). After intravenous immunoglobulin administration she noted a disappearance of the general symptoms and the virus became indetectable by PCR in the serum. However, 1 month later back pain appeared. Magnetic resonance imaging showed bilateral effusions of the apophyseal joints of the lumbar spine (L4–L5). Spine involvement is rarely described during acute or chronic parvovirus B19 infection. In this case it was not possible to determine whether the facet joint arthropathy was reactive or due to persistent articular infection, or induced by immunoglobulin therapy.