Fetal infection with human parvovirus B19 - serious abnormalities rarely occur.
* Fetal anemia * Fetal hydrops * Progressive congestive heart failure * Cytotoxicity * Perivascular calcification * Calcification around blood vessels in brain white matter
Accurate assessment helps identify infectious diseases and prevents avoidable complications. Complete assessment consists of patient history, physical examination, and laboratory data. The history should include the patient's sex, age, address, occupation, and place of work; known exposure to illness and recent medications, including antibiotics; and date of disease onset. Signs and symptoms, including their duration and whether they occurred suddenly or gradually, should be included in the history as well as precipitating factors, relief measures, and weight loss or gain. Detail information about recent hospitalization; blood transfusions; blood donation denial by the Red Cross or other agencies; recent travel or camping trips; exposure to animals; and vaccinations. (See Immunization schedule.) If applicable, ask about possible exposure to sexually transmitted diseases or about drug abuse. Also, try to determine the patient's resistance to infectious disease. Ask about usual dietary patterns, unusual fatigue, and any conditions, such as neoplastic disease or alcoholism, that may predispose him to infection. Notice if the patient is listless or uneasy, lacks concentration, or has any obvious abnormality of mood or affect. In suspected infection, a physical examination must assess the skin, mucous membranes, liver, spleen, and lymph nodes. Check for and make note of the location and type of drainage from any skin lesions. Record skin color, temperature, and turgor; ask if the patient has pruritus. Take his temperature, using the same route consistently, and watch for a fever, which is the best indicator of many infections. (Keep in mind that some patients, such as those who are immunocompromised, are unable to spike a fever.) Note and record the pattern of temperature change and the effect of antipyretics. Be aware that certain analgesics may contain antipyretics. With a high fever, especially in children, watch for seizures. Check the pulse rate. Infection commonly increases the pulse rate, but some infections, notably typhoid fever and psittacosis, may decrease it. Also observe for increased respiratory rate or a change in mental status. In severe infection or when complications are possible, watch for hypotension, hematuria, oliguria, hepatomegaly, jaundice, bleeding from gums or into joints, and an altered level of consciousness. Obtain laboratory studies and appropriate cultures as ordered.