INTRODUCTION

We present the case of a 34-year-old woman, a smoker of 20 cigarettes a day, with no other medical history of interest, who presented to the emergency department with 24-h fever (38.5°C) and holocraneal headache (EVA 8/10), accompanied by odynophagia and otalgia, with no other associated symptoms. She reported that her 4-year-old daughter had suffered a febrile condition with self-limited skin rash last week. Also, the patient completed an antibiotic cycle with amoxicillin-clavulanic acid due to a molar extraction a week ago. On physical examination, only hyperemic oropharynx and painful right submandibular adenopathy stood out, with no palpable adenopathies at other levels, as well as absence of organomegalies, skin rash, or other findings. Blood test and other complementary tests were performed, the results of which are shown in Table 1. The patient was hospitalized in the Internal Medicine service to complete the study, performing some microbiological and autoimmunity tests (also shown in Table 1) as well as a bone marrow biopsy and aspirate.

TABLE 1. Results of the diagnostic tests

Tests	Results
Blood test	Hemoglobin 105 g/L; MCV 86 fL; hematocrit 32.2%; platelets 61 × 109/L; leukocytes 3.09 × 109/L with 1.13 × 109/L neutrophils, 1.46 × 109/L lymphocytes and 0.31 × 109/L monocytes; 3.71 × 109/L reticulocytes; creatinine 0.6 mg/dL; GFR >90 ml/min; proteins 6.3 g/dL; albumin 4 g/dL; Bilirrubin 0.17 mg/dL; LDH 159 U/L; vitamin B12 451 pg/ml; folic acid 3 ng/ml; Fe 141 μg/dL; ferritin 153.8 μg/L, transferrin 303 mg/dL (33% saturation).
Peripheral blood smear	Pancytopenia. A heterogeneous lymphoid population with some large hyperbasophilic cell (2%) with a lymphomonocytic appearance is observed. Neutrophils with vacuolization in all elements without left deviation. Anisothrombia with large platelets, with granulation. Erythroid series with slight anisocytosis and some ovalocyte. Schistocytes not seen.
Chest X-ray	No infiltrates or heart failure data observed.
Electrocardiogram	Sinus rhythm at 70 bpm Normal axis. No acute disturbances of repolarization.
Urine analysis	PH 6; No abnormalities were observed
Pregnancy test	Negative
Blood cultures	Negative
Autoimmunity profile	ANAs: Negative; ac.Anti-DNA: Negative; ANCAs: Negative.
Serologies	EBV: IgG positive; CMV: IgG positive; HIV: Negative; HCV: Negative; HBV: HbsAg negative, anti-HBc negative; HAV: IgM negative; syphilis: IgG + IgM negative; Leishmania: IgG + IgM negative; parvovirus B19: IgM positive; IgG negative.

中文翻译：

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形态学和流式细胞术结果在诊断细小病毒 B19 感染引起的短暂性红细胞再生障碍中的相关性

介绍

我们介绍了一名 34 岁女性，每天吸烟 20 支，无其他病史，因 24 小时发热 (38.5°C) 和全颅性头痛 (EVA) 到急诊科就诊。 8/10），伴有吞咽痛和耳痛，没有其他相关症状。她报告说，她 4 岁的女儿上周发烧，出现自限性皮疹。此外，由于一周前的磨牙拔除，患者完成了阿莫西林-克拉维酸的抗生素周期。体格检查仅突出口咽部充血和疼痛的右下颌下腺病，其他水平未触及淋巴结肿大，无器官肿大、皮疹或其他发现。进行了血液检查和其他辅助检查，结果见表 1。

表 1.诊断测试的结果

测试	结果
验血	血红蛋白 105 克/升；MCV 86 佛罗里达州；红细胞比容 32.2%; 血小板 61  ×  10 9 / L ; 白细胞3.09×  10 9 / L，中性粒细胞1.13  ×  10 9 / L，淋巴细胞1.46×  10 9 / L ，单核细胞0.31×  10 9 / L；3.71 ×  10 9 / L 网织红细胞；肌酐 0.6 mg/dL; GFR >90 毫升/分钟；蛋白质 6.3 g/dL; 白蛋白 4 g/dL; 胆红素 0.17 mg/dL; LDH 159 升/升；维生素 B12 451 皮克/毫升；叶酸 3 ng/ml; 铁 141 微克/分升；铁蛋白 153.8 μg/L，转铁蛋白 303 mg/dL（33% 饱和度）。
外周血涂片	全血细胞减少症。观察到具有一些大嗜碱性细胞（2%）的异质淋巴群，具有淋巴细胞单核细胞外观。中性粒细胞在所有元素中空泡化，无左偏。血小板不等血栓，伴有肉芽。红系系列有轻微的红细胞不均和一些卵圆细胞。未见裂细胞。
胸部 X 光片	未观察到浸润或心力衰竭数据。
心电图	窦性心律 70 bpm 正常轴。无急性复极障碍。
尿液分析	酸碱度 6; 未观察到异常
怀孕测试	消极的
血培养	消极的
自身免疫概况	ANA：阴性；ac.Anti-DNA：阴性；ANCA：否定。
血清学	EBV：IgG阳性；CMV：IgG阳性；艾滋病毒：阴性；丙肝病毒：阴性；HBV：HbsAg 阴性，anti-HBc 阴性；HAV：IgM 阴性；梅毒：IgG + IgM 阴性；利什曼原虫：IgG + IgM 阴性；细小病毒 B19：IgM 阳性；IgG 阴性。