Myocarditis Associated with Human Parvovirus B-19 Infection in Children: A Case Series of Three Patients During the 2024 European Epidemic and a Brief Literature Review

Background: Human Parvovirus B19 (PVB19) is a globally distributed virus associated with a wide range of clinical manifestations, from mild erythema infectiosum to severe, life-threatening complications including myocarditis. Epidemiological data from early 2024 indicate an increasing prevalence of PVB19 infections in Europe, raising concerns regarding its potential complications in pediatric populations. Objective: This study describes three pediatric cases of severe PVB19 infection. Cases presentation: We retrospectively analyzed three cases of PVB19 infection diagnosed at a tertiary care hospital in Bologna, Italy, between March and June 2024 who presented with viral myocarditis. They all required intensive care management, with one patient experiencing cardiac arrest and requiring mechanical ventilation. Despite the severity of their conditions, all three recovered following inotropic support and immunoglobulin therapy. All patients tested positive for PVB19 DNA, and no alternative viral causes were identified. Conclusions: This case series underscores the wide clinical spectrum of PVB19 infection and its potential for severe, life-threatening complications in pediatric patients. Considering the recent rise in PVB19 cases, clinicians should maintain a high index of suspicion for myocarditis in children presenting with severe symptoms. Early recognition and prompt supportive management are crucial in improving outcomes. Further research may help to better understand PVB19 pathogenesis and develop targeted preventive strategies.