Human Parvovirus B19 Co-infection in a Patient with Hemorrhagic Fever with Renal Syndrome: A Case Report

Hemorrhagic fever with renal syndrome (HFRS), a significant rodent-borne disease in Eurasia, particularly in China, can lead to acute kidney injury, coagulation abnormalities, and even death. Co-infection with other pathogens typically exacerbates and complicates this disease. In this study, through metagenomic analysis, we identified the co-infection with human parvovirus B19 (PV B19) in a 41-year-old man with HFRS and no other underlying disease. In addition to typical HFRS symptoms, he exhibited a longer duration of renal injury than other patients with HFRS, along with a persistent decrease in erythrocytes and hemoglobin. The complete PV B19 genome was amplified and showed 86.6–99.7% nucleotide identity and 94.0–100.0% amino acid identity to known PV B19 strains. Phylogenetic analysis revealed that the newly identified PV B19 strain clustered with genotype 1a and had the closest relationship with strain HZ1/China-HZ from Zhejiang Province, China. This study emphasizes that routine screening for PV B19 co-infection in patients with HFRS is essential, particularly in cases with a prolonged course, and persistent decreases in erythrocytes and hemoglobin.