Syndromes Of Coxsackieviruses

Ask The Expert Dr. Robert Ancona, St. Joseph Medical Center

July 20, 2009

Coxsackieviruses can cause many clinical syndromes that overlap with other viruses, including common cold symptoms, fever, sore throat, rashes, eye infections and diarrhea, says Dr. Robert Ancona, chief of pediatrics at St. Joseph Medical Center.

He writes that the three most identifiable syndromes caused by coxsackieviruses are: acute hemorrhagic conjunctivitis, herpangina and hand, foot and mouth disease.

* Preschool-age children, especially those 11/2 to 3 years old, are most at risk to catch these viruses, though any age group can be affected, especially with acute hemorrhagic conjunctivitis. These viruses are often passed around by a fecal-to-mouth route or direct contact with infected secretions from the mouth or eyes. Therefore, good hand washing, as with many infectious illnesses, is extremely important in preventing infections.

* The symptoms of acute hemorrhagic conjunctivitis are painful red eyes, tearing and swelling of the eyelids, usually within one to three days of swimming in a communal pool. Outbreaks with numerous cases usually occur. Symptoms can last a week to 10 days.

* Herpangina usually produces a high fever (101 to 104 degrees), irritability, decreased appetite and multiple blisters or ulcers in the back of the throat. Younger children often drool more than normal and their symptoms can last up to seven days, though older children may recover in three days.

Hand, foot and mouth disease has similar symptoms, plus a blistering rash on the hands, feet, and/or buttocks, usually below the skin's surface and which may begin as papules. The blisters are usually not painful.

* There is no specific treatment for any of the coxsackie syndromes. But the symptoms can be treated, for example, with analgesics for fever and pain and with fluids, especially cool ones, that may relieve throat pain. For conjunctivitis, try cool compresses for relief.

* Complications from these infections are uncommon, but for younger infants who refuse to drink due to blisters in their throats, dehydration is a risk, so proper fluids are very important. In rare cases, the abrupt onset of high fever can trigger a febrile seizure in those who are susceptible. Most importantly, children are contagious throughout the entire illness and must not be in a school or communal setting until all symptoms go away, which can be as long as a week.

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