COVID-19, parvovirus and acute HIV infection in the gamut of diagnosis of fever and rash

Coronavirus disease-19 (COVID-19) patients continue to experience different symptoms each day. Many patients were seen with common symptoms such as fever, fatigue, myalgia, respiratory symptoms (e.g., dry cough, dyspnea), smell and taste disorders, gastrointestinal symptoms, and dermatological findings. Although, fever lasting <7 days has been reported in most patients, it has been seen in patients with persistent or recurrent fever patterns in the second week of illness. Although, any symptoms accompanying fever during the pandemic suggest the diagnosis of COVID-19, other etiologies should also be kept in mind. In this case report, we present two patients who were admitted with fever and rash were initially thought to have COVID-19 but were diagnosed with acute parvovirus infection and acute HIV infection finally. These cases are presented to draw attention to the importance of taking a good history and making a rational differential diagnosis.

___

  • Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020;8:475-81. doi: 10.1016/S2213-2600(20)30079-5.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-ınfected pneumonia in Wuhan, China. JAMA 2020;323:1061-9. doi: 10.1001/jama.2020.1585.
  • Zheng F, Tang W, Li H, Huang YX, Xie YL, Zhou ZG. Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha. Eur Rev Med Pharmacol Sci 2020;24:3404-10. doi: 10.26355/eurrev_202003_20711.
  • Lechien JR, Chiesa-Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S. Loss of smell and taste in 2013 European patients with mild to moderate COVID-19 [published online ahead of print, 2020 May 26]. Ann Intern Med 2020;10.7326/M20-2428. doi:10.7326/M20-2428
  • Nobel YR, Phipps M, Zucker J, et al. Gastrointestinal symptoms and coronavirus disease 2019: A case-control study from the United States. Gastroenterology 2020;159:373-5.e2. doi: 10.1053/j.gastro.2020.04.017.
  • Sachdeva M, Gianotti R, Shah M, et al. Cutaneous manifestations of COVID-19: Report of three cases and a review of literature. J Dermatol Sci 2020;98:75-81. doi: 10.1016/j.jdermsci.2020.04.011.
  • Deborah H L Ng, Chiaw Yee Choy, Yi-Hao Chan, et al. National Centre for Infectious Diseases COVID-19 Outbreak Research Team, fever patterns, cytokine profiles, and outcomes in COVID-19. Open Forum Infect Dis Volume 2020;9:ofaa375. doi: 10.1093/ofid/ofaa375
  • Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA. Cutaneous manifestations in patients with COVID-19: a preliminary review of an emerging issue. Br J Dermatol 2020 ;10:1111/bjd.19264. doi: 10.1111/bjd.19264.
  • Republic of Turkey Ministry of Health Directorate 2020. COVID-19 (SARS-CoV-2 Infection) Guide (in Turkish). Available at: https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf. Accessed on: 14.04. 2020.
  • Kang JH. Febrile Illness with skin rashes. Infect Chemother 2015;47:155-66. doi: 10.3947/ic.2015.47.3.155.
  • Tabak F, Murtezaoglu A, Tabak O, et al. Clinical features and etiology of adult patients with fever and rash. Ann Dermatol 2012;24:420-5. doi: 10.5021/ad.2012.24.4.420.
  • Saffar MJ, Saffar H, Shahmohammadi S. Fever and rash syndrome: A review of clinical practice guidelines in the differential diagnosis. J Pediatr Rev 1.2 2013: 42-54. Available at: http://jpr.mazums.ac.ir/article-1-57-en.html Accessed on: 17.04.2020
  • Alexander V, Das S, Mangan AS, Iyadurai R. Acute parvovirus B19 infection presenting as rheumatoid arthritis mimic. J Family Med Prim Care 2019;8:1257-9. doi: 10.4103/jfmpc.jfmpc_25_19.
  • Cooray Mi Manolakos JJ, Douglas SW, Haider S, Patel A. Parvovirus infection mimicking systemic lupus erythematosus. Case Reports. CMAJ 2013; 185: 1342-4. doi: 10.1503/cmaj.121565
  • Woolina U, Karadag AS, Rowland-Payne C, Cihrac A, Lotti T. Cutaneous signs in COVID-19 patients: A review. Derm Ther 2020;e13549 doi:10.1111/dth.13549.
  • Waza K, Inoue K, Matsumura S. Symptoms associated with parvovirus B19 infection in adults: a pilot study. Intern Med 2007; 46:1975. doi: 10.2169/internalmedicine.46.0366
  • Robb ML, Eller LA, Kibuuka H, et al. Prospective study of acute HIV-1 ınfection in adults in East Africa and Thailand. N Engl J Med 2016;374:2120-30. doi: 10.1056/NEJMoa1508952
  • Park JH, Wook J, Sang-Woo K, et al. The clinical manifestations and chest computed tomography findings of coronavirus disease 2019 (COVID-19) patients in China: A proportion meta-analysis. Clin Exp Otorhinolaryngol 2020;13:95-105. doi: 10.21053/ceo.2020.00570
  • Galván Casas C, Català A, Carretero Hernández G, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol 2020;183:71-7. doi: 10.1111/bjd.19163
  • Bouaziz JD, Duong T, Jachiet M, et al. Vascular skin symptoms in COVID-19: a French observational study [published online ahead of print, 2020 Apr 27]. J Eur Acad Dermatol Venereol 2020;34:e451-e452. doi: 10.1111/jdv.16544