Parvovirus B19 Infection Medication

Updated: Nov 14, 2016
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Russell W Steele, MD  more...
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Medication

Medication Summary

No antiviral therapy is available to treat parvovirus B19 (B19V) infections. Children rarely require specific therapy other than acetaminophen for fever.

In patients with postinfectious arthritis, acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) usually provide symptomatic relief. Because the use of aspirin in children with other viral illnesses has been associated with Reye syndrome, aspirin use is not recommended in children with B19V infection. If children have pruritus from the parvovirus B19 rash, oral antihistamines (eg, diphenhydramine) and starch baths typically provide relief.

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Antipyretic agents

Class Summary

These agents decrease or eliminate fever by acting at the level of the hypothalamus (acetaminophen) or by decreasing the activity of the enzyme cyclooxygenase, thereby decreasing the production of prostaglandins (NSAIDs).

Acetaminophen (Tylenol, Feverall, Tempra, Aspirin Free Anacin, Panadol)

Reduces fever by acting directly on hypothalamic heat-regulating centers, which increases dissipation of body heat via vasodilation and sweating.

Ibuprofen (Motrin, Ibuprin, Advil)

One of the few NSAIDs indicated for reduction of fever.

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Immunologic effectors

Class Summary

These agents are purified preparations of gamma globulin. Immunologic effectors are derived from large pools of human plasma and comprise 4 subclasses of antibodies, approximating the distribution of human serum.

Immunity to B19V infection appears to be purely humoral (ie, mediated via immunoglobulins). The role, if any, that cell-mediated immunity plays in providing immunity to B19V is unknown. As a result of the high seroprevalence of IgG against parvovirus among adults in the general population who have recovered from infection, the antiparvovirus IgG titer in IVIG is probably sufficient to provide passive immunity for the clearance of virus in immunocompromised hosts with chronic B19V infection.

Immune globulin, intravenous (Gammagard S/D, Carimune NF, Gammar-P)

Provides passive immunization against a broad spectrum of infectious agents. Neutralizes circulating myelin antibodies through anti-idiotypic antibodies; down-regulates proinflammatory cytokines, including INF-gamma; blocks Fc receptors on macrophages; suppresses inducer T and B cells and augments suppressor T cells; blocks complement cascade; promotes remyelination; may increase CSF IgG (10%).

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Antihistamines

Class Summary

These agents decrease or prevent allergic symptoms caused by histamine receptors from mast cells.

Diphenhydramine (Benadryl)

First-generation antihistamine that binds to H1 receptors in the CNS and the body.

Competitively blocks histamine from binding to H1 receptors. As a result of CNS penetration, diphenhydramine frequently causes drowsiness. A small percentage of children paradoxically respond to diphenhydramine with agitation.

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