It is well established that acute parvovirus B19 (B19V) infection in adults is associated with peripheral inflammatory arthritis.1 Joint involvement is usually symmetric and acute, most commonly involving the knees, feet, wrists, and small joints of the hands.2
We present a rare case of B19V arthritis presenting as spinal disease. A 50-year-old male patient with no medical history presented to his general practitioner with fevers, cervical spine pain, and stiffness. This was following contact with his child, who was unwell with an acute B19V infection. The man was confirmed to have an acute B19V infection on serology. He had raised inflammatory markers, with C-reactive protein of 46 mg/L (normal < 5 mg/L) and erythrocyte sedimentation rate of 47 mm/h (normal < 12 mm/h). Magnetic resonance imaging of his cervical spine (Figure 1) demonstrated edema posterior to the cervical spine, suggesting interspinous bursitis from C2 to C5.
T2-weighted MRI of the cervical spine. (A) Sagittal view showing edema posterior to the cervical spine (arrows), suggesting interspinous bursitis from C2 to C5. (B) Axial view showing edema posterior to the cervical spine (arrow). MRI: magnetic resonance imaging.
Following an initial poor response to nonsteroidal antiinflammatory drugs, the patient was treated with a 7-day course of oral prednisolone. At 10 weeks from initial presentation, he had complete resolution of his symptoms and normalization of inflammatory markers.
This case report demonstrates B19V infection presenting as spinal disease, which has not previously been documented. It is important to consider B19V infection as a differential for inflammatory spinal disease, as well as for peripheral inflammatory arthritis.
ACKNOWLEDGMENT
We thank Dr. Matthew Andrews for providing the radiology images.
Footnotes
The authors declare no conflicts of interest relevant to this article. Ethics approval was not required according to the authors’ institution. Informed written consent was obtained from the patient. The guideline for publication of case study reports for the authors’ institution was adhered to.
- Copyright © 2025 by the Journal of Rheumatology
