Chronic Parvovirus B19 infection in a patient with Ewing’s sarcoma-a case report - Abstract
Human parvo virus B19 (B19V) is a small single stranded DNA virus with known tropism and cytotoxicity for erythroid progenitors. Its infection is associated with various hematological disorders like aplastic crisis, erythroid hypoplasia, idiopathic thrombocytopenic purpura etc. Here we are presenting a case of Parvo virus B19 infection in a patient treated for Ewing’s sarcoma. A 13 year old boy diagnosed as Ewing’s sarcoma on gluteal mass biopsy, received 14 cycles of chemotherapy with few intermittent cycles of radiotherapy, presented with persistent anemia post treatment. Bone marrow biopsies before initiation and during the course of treatment showed no evidence of metastasis. Patient developed anemia during therapy which persisted even after completing the course of treatment. So again bone marrow examination was performed 4 months after the last cycle of chemotherapy to investigate anemia. It showed paucity of erythroid precursors and gaint basophilic pronormoblasts with intra-nuclear inclusions pathognomonic for Parvo virus B19. Serology for Parvo virus B19 antibodies was performed which reported positivity. This case highlights the morphology of human parvovirus B19 inclusions in a post chemotherapy immunocompromised child.