Coxsackie viral infection in Infant/Neonate
All age groups are affected, but neonatal infection with these viruses may progress to severe organ dysfunction and death. Additionally, immunosuppressed patients may develop severe and fatal infection of the central nervous system.
Coxsackieviruses can cause an upper respiratory infection. The illness may resemble the common cold. Differentiation between an infection caused by this virus and other similar viruses is not usually possible on clinical grounds alone. Acute hemorrhagic conjunctivitis has been reported with infection with a certain viral serotype.
Coxsackieviruses are frequently associated with rashes. The rash is usually not specific enough to allow a clinical diagnosis. One exception is hand-foot-and-mouth disease, which can be caused by certain coxsackievirus serotypes. This disease is most common in children. Patients have sore throat and fever. Vesicles are present in the oral cavity. Vesicular and papular lesions are also seen on the extensor surfaces of the hands and feet.
Herpangina is another clinical syndrome that has been associated with the coxsackieviruses. Patients frequently have fever, sore throat, and headache. This is followed over the course of hours to days by an eruption on the soft palate, uvula, and tonsils. The eruption begins as macules that progress to papules and then to vesicles.
Coxsackieviruses can result in a variety of neurological manifestations, including acute viral meningitis. Patients present acutely or subacutely with headache. Fever, chills, and meningismus may or may not be present. Patients may have concomitant pharyngitis. Encephalitis due to coxsackieviruses has also been reported. Symptoms may be mild or severe and be associated with seizures or coma. There has been an association made between a serotype of coxsackievirus and acute flaccid paralysis, with symptoms similar to poliomyelitis.
Coxsackieviruses can cause pleurodynia (an acute infection of skeletal muscle). Patients have fever and sharp pain in the chest and upper abdomen. Certain serotypes can also cause myopericarditis.
Diagnosis is made by viral culture or by isolating viral RNA by nucleic acid testing. No specific antiviral therapy is available.
B97.11 – Coxsackievirus as the cause of diseases classified elsewhere
186658007 – Coxsackie virus disease