Coxsackie virus: Difference between revisions

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*Throat and lesion swabs  
*Throat and lesion swabs  
*[[Tzanck test]]
*[[Tzanck test]]
|
| [[File:Hand foot mouth disease 15.jpeg|Hand foot and mouth disease|400px]]
|-
|-
|[[Acute hemorrhagic conjunctivitis]]<ref name="pmid1088513">{{cite journal| author=Yin-Murphy M| title=Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis). | journal=Bull World Health Organ | year= 1976 | volume= 54 | issue= 6 | pages= 675-9 | pmid=1088513 | doi= | pmc=2366581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1088513  }} </ref><ref name="pmid26602522">{{cite journal| author=Pinto RD, Lira RP, Arieta CE, Castro RS, Bonon SH| title=The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil. | journal=Clinics (Sao Paulo) | year= 2015 | volume= 70 | issue= 11 | pages= 748-50 | pmid=26602522 | doi=10.6061/clinics/2015(11)06 | pmc=4642493 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26602522  }} </ref><ref name="pmid26077630">{{cite journal| author=Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB| title=Adenoviral keratoconjunctivitis. | journal=Surv Ophthalmol | year= 2015 | volume= 60 | issue= 5 | pages= 435-43 | pmid=26077630 | doi=10.1016/j.survophthal.2015.04.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26077630  }} </ref>
|[[Acute hemorrhagic conjunctivitis]]<ref name="pmid1088513">{{cite journal| author=Yin-Murphy M| title=Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis). | journal=Bull World Health Organ | year= 1976 | volume= 54 | issue= 6 | pages= 675-9 | pmid=1088513 | doi= | pmc=2366581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1088513  }} </ref><ref name="pmid26602522">{{cite journal| author=Pinto RD, Lira RP, Arieta CE, Castro RS, Bonon SH| title=The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil. | journal=Clinics (Sao Paulo) | year= 2015 | volume= 70 | issue= 11 | pages= 748-50 | pmid=26602522 | doi=10.6061/clinics/2015(11)06 | pmc=4642493 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26602522  }} </ref><ref name="pmid26077630">{{cite journal| author=Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB| title=Adenoviral keratoconjunctivitis. | journal=Surv Ophthalmol | year= 2015 | volume= 60 | issue= 5 | pages= 435-43 | pmid=26077630 | doi=10.1016/j.survophthal.2015.04.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26077630  }} </ref>
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*[[Breathlessness]]
*[[Breathlessness]]
|
|
*Clinical
*[[EKG]]
*[[EKG]]
*Cardiac Biomarkers
*Cardiac Biomarkers
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**Serum [[LDH]] , serum [[myoglobin]] and [[SGOT]] ([[AST]])
**Serum [[LDH]] , serum [[myoglobin]] and [[SGOT]] ([[AST]])
*[[Echocardiography]] and [[Percardiocentesis]]
*[[Echocardiography]] and [[Percardiocentesis]]
| [[File:Pericarditis 0007.jpg|Pericarditis|400px]]
| [[File:Pericarditis 0007.jpg|Pericarditis|400x600px]]
|-
|-
|[[Myocarditis]]
|[[Myocarditis]]<ref name=Feldman>Feldman AM, McNamara D. Myocarditis. ''[[New England Journal of Medicine|N Engl J Med]]'' 2000;343:1388-98. PMID 11070105.</ref><ref name="pmid11693753">{{cite journal| author=Sarda L, Colin P, Boccara F, Daou D, Lebtahi R, Faraggi M et al.| title=Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms. | journal=J Am Coll Cardiol | year= 2001 | volume= 37 | issue= 3 | pages= 786-92 | pmid=11693753 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11693753  }} </ref>
|
|
|
* [[Chest pain]] often described as stabbing, pleuritic or sharp in character
* Swelling of the feet
* [[Breathlessness]]
* [[Dyspnea on exertion]]
* [[Orthopnea]]
* [[Palpitation]]s
* [[Syncope]] in setting of high grade [[AV block]]
* [[Fever]] (especially when infectious, e.g. in [[rheumatic fever]])
* [[Joint pains]]
* [[Fatigue]]
* [[Cyanosis]]
|
|
*Clinical
*Markers of Myonecrosis
**[[Creatine kinase]] (CK-MB)
**[[troponin|Cardiac troponin]] I (cTnI) or T (cTnT) are elevated more frequently than CK-MB (34-53% versus 2-6 %) as reported in two series.<ref name="pmid8994432">{{cite journal| author=Smith SC, Ladenson JH, Mason JW, Jaffe AS| title=Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates. | journal=Circulation | year= 1997 | volume= 95 | issue= 1 | pages= 163-8 | pmid=8994432 | doi= | pmc= | url= }} </ref><ref name="pmid9350939">{{cite journal| author=Lauer B, Niederau C, Kühl U, Schannwell M, Pauschinger M, Strauer BE et al.| title=Cardiac troponin T in patients with clinically suspected myocarditis. | journal=J Am Coll Cardiol | year= 1997 | volume= 30 | issue= 5 | pages= 1354-9 | pmid=9350939 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9350939  }} </ref><ref name="pmid8994432">{{cite journal| author=Smith SC, Ladenson JH, Mason JW, Jaffe AS| title=Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates. | journal=Circulation | year= 1997 | volume= 95 | issue= 1 | pages= 163-8 | pmid=8994432 | doi= | pmc= | url= }} </ref><ref name="pmid12211203">{{cite journal| author=Soongswang J, Durongpisitkul K, Ratanarapee S, Leowattana W, Nana A, Laohaprasitiporn D et al.| title=Cardiac troponin T: its role in the diagnosis of clinically suspected acute myocarditis and chronic dilated cardiomyopathy in children. | journal=Pediatr Cardiol | year= 2002 | volume= 23 | issue= 5 | pages= 531-5 | pmid=12211203 | doi= | pmc= | url= }} </ref>
**[[Lactate dehydrogenase]] (LDH)
**[[Alanine transaminase]] (ALT)
**[[Aspartate transaminase]] (AST)
| [[File:Acute rheumatic myocarditis case 1.jpg|Viral myocarditis|400px]]
|-
|-
|[[Pericardial effusion]]
|[[Pericardial effusion]]
|
|
*[[Chest pain]]
*Dyspnea
*Nonspecific chest discomfort
|
|
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*Clinical
* Thoracic [[X-ray]] showing the presence of an enlarged cardiac silhouette with clear lungs
*[[CT scan]]
| [[File:Pericardial effusion 1.jpg|Pericardial effusion|400px]]
|-
|-
|[[Pleurodynia]]
|[[Pleurodynia]]
|
|
*[[Fever]]
*[[Headache]]
*Attacks of severe pain in the lower chest, often on one side<ref name="pmid13042253">{{cite journal |author=WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD |title=Oxford epidemic of Bornholm disease, 1951 |journal=Br Med J |volume=1 |issue=4824 |pages=1345–51 |year=1953 |month=June |pmid=13042253 |pmc=2016648 |doi= |url=}}</ref>
*[[Pleuritic pain]] with the slightest movement of the [[rib cage]]
*Dyspnea
*Very few have classic muscle pain in the chest and upper abdomen
*May be accompanied by a panic attack
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*Clinical
*CXR
|
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|-
|-
|[[Hepatitis]]
|[[Hepatitis]]
|
|
* [[Abdominal pain]] or distention
* [[Gynecomastia]]
* Dark urine and pale or [[clay-colored stools]]
* [[Fatigue]]
* [[Fever]], usually low-grade
* General itching
* [[Jaundice]] (yellowing of the skin or eyes)
* [[Loss of appetite]]
* [[Nausea]] and [[vomiting]]
* [[Weight loss]]
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|
* [[Liver function tests]]
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|-
|-
|[[Sjogren's syndrome]]
|[[Sjogren's syndrome]]
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*Dry eyes
*Dry mouth
*[[Xerosis]]
*[[Raynaud phenomenon]] and [[vasculitis]]
*Joint and muscle abnormalities
*[[Interstitial lung disease]]
*Gastrointestinal manifestations
*CNS involvement
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|
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*Clinical
*Autoantibodies
**Anti-Ro/SSA and anti-La/SSB antibodies
**Anti-centromere antibodies
*Biopsy of organ involved
| [[File:Sjogren's syndrome 001.jpg|Sjogren's syndrome|400px]]
|}</small>
|}</small>
{{viruses}}
{{viruses}}

Revision as of 19:06, 27 March 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Coxsackie Virus

Overview

Classification

Coxsackie A virus
Coxsackie B virus
Coxsackie B4 virus

Differential Diagnosis

Overview

Coxsackie (virus) is a cytolytic virus of the Picornaviridae family, an enterovirus (a group containing the polioviruses, coxsackieviruses, and echoviruses). There are 61 non-polio enteroviruses that can cause disease in humans, of which 23 are Coxsackie A viruses (6 are Coxsackie B viruses). Enterovirus are the second most common viral infectious agents in humans (after the rhinoviruses)

Classification

Coxsackie viruses consist of Coxsackie A virus and Coxsackie B virus. Coxsackie B virus has 6 serotypes, one of the significant serotypes is called Coxsackie B4 virus.

 
 
 
 
 
 
 
 
 
 
 
 
Coxsackie Virus
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Coxsackie A virus
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Coxsackie B virus[1]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Common Coxsackie B virus diseases
 
 
 
 
 
Coxsackie B4 virus diseases
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
• Hand, foot and mouth disease
• Acute hemorrhagic conjunctivitis
• Herpangina
• Aseptic meningitis
 
 
 
 
 
 
 
 
 
 
 
• Pericarditis
• Myocarditis
• Pericardial effusion
• Pleurodynia
• Hepatitis
• Sjogren's syndorme
 
 
 
 
 
• Diabetes mellitus
• Acute flaccid myelitis[2]
 
 

Differential Diagnosis

Coxsackie A virus and Coxsackie B virus can cause multiple diseases in humans. The wide array of diseases caused by Coxsackie viruses can be differentiated from one another easily on the basis of involvement of the organs systems, clinical presentation and diagnostic techniques.

Virus Type Disease Clinical Features Diagnosis Image
Coxscakie A virus Hand foot and mouth disease
  • Fever
  • Headache
  • Loss of appetite
  • Maculopapular or vesicular rash with very small blisters on hands, feet, and diaper area; may be tender or painful if pressed
  • Sore throat*

Ulcers in the throat (including tonsils), mouth, and tongue

Hand foot and mouth disease
Acute hemorrhagic conjunctivitis[3][4][5]
  • Rapidly progressive
  • Infection starts ipsilaterally, but rapidly involves the fellow eye within 1 or 2 days
  • Eyelids swelling
  • Tearing
  • Eye redness
  • Severe eye pain
  • Purulent discharge
  • Subconjunctival hemorrhage
 Viral conjunctivitis
Herpangina
  • Sudden fever
  • Sore throat and dysphagia- May occur up to 24 hours before the appearance of the enanthem
  • Vomitting
  • Abdominal pain
  • Myalgia
  • Headache
  • Pharyngeal lesions
  • Primarily clinical
  • Pharyngeal viral cultures may be helpful
  • Approximately 1 week after infection, type-specific antibodies appear in the blood
 Herpangina
Aseptic Meningitis
Coxsackie B virus Pericarditis Pericarditis
Myocarditis[10][11] Viral myocarditis
Pericardial effusion
  • Clinical
  • Thoracic X-ray showing the presence of an enlarged cardiac silhouette with clear lungs
  • CT scan
 Pericardial effusion
Pleurodynia
  • Fever
  • Headache
  • Attacks of severe pain in the lower chest, often on one side[15]
  • Pleuritic pain with the slightest movement of the rib cage
  • Dyspnea
  • Very few have classic muscle pain in the chest and upper abdomen
  • May be accompanied by a panic attack
  • Clinical
  • CXR
Hepatitis
Sjogren's syndrome
  • Clinical
  • Autoantibodies
    • Anti-Ro/SSA and anti-La/SSB antibodies
    • Anti-centromere antibodies
  • Biopsy of organ involved
 Sjogren's syndrome

Template:Baltimore classification Template:Viral diseases


Template:WikiDoc Sources

  1. ↑ Fields, Bernard N. (1985). Fields Virology. New York: Raven Press. pp. 739–794. ISBN 0-88167-026-X. Unknown parameter |coauthors= ignored (help)
  2. ↑ Cho SM, MacDonald S, Frontera JA (2017). "Coxsackie B3/B4-Related Acute Flaccid Myelitis". Neurocrit Care. doi:10.1007/s12028-017-0377-8. PMID 28324262.
  3. ↑ Yin-Murphy M (1976). "Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis)". Bull World Health Organ. 54 (6): 675–9. PMC 2366581. PMID 1088513.
  4. ↑ Pinto RD, Lira RP, Arieta CE, Castro RS, Bonon SH (2015). "The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil". Clinics (Sao Paulo). 70 (11): 748–50. doi:10.6061/clinics/2015(11)06. PMC 4642493. PMID 26602522.
  5. ↑ Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB (2015). "Adenoviral keratoconjunctivitis". Surv Ophthalmol. 60 (5): 435–43. doi:10.1016/j.survophthal.2015.04.001. PMID 26077630.
  6. ↑ Spodick DH (2003). "Acute pericarditis: current concepts and practice". JAMA. 289 (9): 1150–3. doi:10.1001/jama.289.9.1150. PMID 12622586.
  7. ↑ Karjalainen J, Heikkila J (1986). ""Acute pericarditis": myocardial enzyme release as evidence for myocarditis". Am Heart J. 111 (3): 546–52. doi:10.1016/0002-8703(86)90062-1. PMID 3953365.
  8. ↑ Bonnefoy E, Godon P, Kirkorian G, Fatemi M, Chevalier P, Touboul P (2000). "Serum cardiac troponin I and ST-segment elevation in patients with acute pericarditis". Eur Heart J. 21 (10): 832–6. doi:10.1053/euhj.1999.1907. PMID 10781355.
  9. ↑ Imazio M, Demichelis B, Cecchi E, Belli R, Ghisio A, Bobbio M, Trinchero R (2003). "Cardiac troponin I in acute pericarditis". J Am Coll Cardiol. 42 (12): 2144–8. doi:10.1016/j.jacc.2003.02.001. PMID 14680742.
  10. ↑ Feldman AM, McNamara D. Myocarditis. N Engl J Med 2000;343:1388-98. PMID 11070105.
  11. ↑ Sarda L, Colin P, Boccara F, Daou D, Lebtahi R, Faraggi M; et al. (2001). "Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms". J Am Coll Cardiol. 37 (3): 786–92. PMID 11693753.
  12. ↑ 12.0 12.1 Smith SC, Ladenson JH, Mason JW, Jaffe AS (1997). "Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates". Circulation. 95 (1): 163–8. PMID 8994432.
  13. ↑ Lauer B, Niederau C, Kühl U, Schannwell M, Pauschinger M, Strauer BE; et al. (1997). "Cardiac troponin T in patients with clinically suspected myocarditis". J Am Coll Cardiol. 30 (5): 1354–9. PMID 9350939.
  14. ↑ Soongswang J, Durongpisitkul K, Ratanarapee S, Leowattana W, Nana A, Laohaprasitiporn D; et al. (2002). "Cardiac troponin T: its role in the diagnosis of clinically suspected acute myocarditis and chronic dilated cardiomyopathy in children". Pediatr Cardiol. 23 (5): 531–5. PMID 12211203.
  15. ↑ WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD (1953). "Oxford epidemic of Bornholm disease, 1951". Br Med J. 1 (4824): 1345–51. PMC 2016648. PMID 13042253. Unknown parameter |month= ignored (help)
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