Coxsackie virus
Background:
The Enterovirus genus of the picornavirus family is a large group of viruses associated with a spectrum of diseases ranging from paralytic poliomyelitis to mild, non-specific febrile illness and rarely associated with disease of the gastrointestinal tract. They are worldwide in distribution but more than 90% of infections with enteroviruses are subclinical.
The Enterovirus genus comprises several subgroups of which the following may cause disease in humans:
- Polioviruses (types 1–3). Gr. polios=grey, myelos=marrow.
- Coxsackie viruses, Group A (types 1–22, 24) and Group B (types 1–6).
- Coxsackie is the village in the USA where the patients from whom theseviruses were first isolated lived.
- Echoviruses (types 1–9, 11–27). Enteric cytopathogenic human orphan viruses, originally considered not to be associated (‘orphan’) with human disease.
- Newer enteroviruses (types 29–34, 68–72). Human enterovirus 72 is hepatitis A virus.
Transmission:
Enteroviruses spread from person to person mainly by the faecal–oral route, and to a lesser degree by the respiratory route. Some types associated with conjunctivitis spread by direct contact.
Incubation:
The incubation period is 5–14 (2–25) days. Enterovirus conjunctivitis has an incubation period of 12–24 hours.
Symptoms & Signs:
General: Fever, Headache, Malaise
Neurological: Meningitis, rarely Encephalitis and Transient Paralysis
Other: Epidemic Myalgia/Pleurodynia (Bornholm Disease), Myocarditis, Pericarditis, Generalized Disease in the Newborn, Vesicular and Maculopapular Exanthems, Haemorrhagic
Conjunctivitis
Usual duration is a few days to about 1 week.
- The coxsackieviruses and echoviruses multiply primarily in lymphoid tissue in the pharynx and the small intestine.
- In about 5% of cases virus may spread to other target organs, the main ones being the meninges, the brain and spinal cord, myocardium and pericardium, striated muscles and skin.
- Infection leads to lasting type-specific immunity.
- Fever of short duration and sometimes a rash or mild upper respiratory symptoms are the most frequent clinical diseases.
- A few cases progress to one of the following syndromes:
- Aseptic meningitis: In typical cases a biphasic course is seen. After an interval of 1–2 days with few or no symptoms, the temperature rises again to 38–39oC, accompanied by headache, neck stiffness and vomiting. A non-specific maculopapular rash, sometimes with petechial elements, may be seen. The CSF is clear with slight or moderate elevation of cell count and protein content, but with normal sugar content. The illness may last for 2–10 days, sometimes followed by a convalescent phase of rather long duration. The prognosis is good as most patients recover completely.
- Meningoencephalitis or encephalitis may occur in some cases. In differential diagnosis, meningitis caused by other viruses and early or inadequately treated bacterial meningitis which may mimic aseptic meningitis should be considered. Note a petechial rash is also seen in meningococcal disease. Lymphocytes are seen in the CSF (tuberculous, listerial and cryptococcal meningitis), but usually the glucose content is lowered. Complications are transient paralysis and polio-like disease.
- Epidemic myalgia/pleurodynia (Bornholm disease). This is a painful inflammation of the muscles, most pronounced in the intercostal muscles or abdominal muscles, accompanied by pain that may be severe (devil’s grip) and resemble ischaemic heart disease or ‘acute abdomen’. The pain is often intermittent for periods of 2–10 hours, combined with rise in temperature. The illness lasts for 4–6 days, but relapses in the following weeks are not infrequent. Complete recovery is the rule.
- Myocarditis/pericarditis. This is observed in 5% of patients with coxsackie B virus infections. Typical features are fever, chest pain and dyspnoea. Other signs are pericardial rub, heart dilatation and arrhythmias. Heart failure may occur. The illness usually lasts for 1–2 weeks. Relapse may occur during the following weeks and months in 20% of patients. The most important differential diagnoses are cardiac ischaemia, infarction and myopericarditis of other aetiology.
- Neonatal myocarditis. Some enteroviruses, mostly coxsackie B3 and 4, may cause a severe, often fatal disease in infants characterized by sudden onset, lethargy, tachycardia, dyspnoea and cyanosis. It is a systemic infection as many organs (heart, brain, liver, pancreas) are involved. The virus is transmitted from mother to child just before or at birth.
- Herpangina. The illness is seen mainly in children. Some 8–10 vesicles or small ulcers, 1–3mm in diameter, are seen on the posterior pharyngeal wall. There is pain on swallowing and usually slight fever of a few days’ duration. Differential diagnoses are herpes simplex, varicella, aphthous stomatitis.
- Hand, foot and mouth disease. This occurs most often in children. Moderate fever of 38–39oC may be seen. Vesicles up to 5mm in diameter are localized on the buccal mucosa and tongue as well as on the hands and feet. NO PREGNANCY RISK.
- Rashes. Maculopapular rashes (‘rubelliform’ or non-specific) are seen quite frequently in coxsackie A and echovirus infections, accompanied by pharyngitis and fever. A rash is sometimes seen in the course of meningitis. Differential diagnoses are erythema infectiosum, rubella, measles and rashes seen in meningococcal disease.
- Acute haemorrhagic conjunctivitis. This eye disease is characterized by pain, swelling of the eyelids and subconjunctival haemorrhages of a few days’ duration, usually healing spontaneously in less than a week. It is highly contagious, with an incubation time of 12–24 hours, and spreads by direct contact. Extensive epidemics have been observed in the Far East (caused by coxsackie A type 24) and in Africa, Japan and India (enterovirus type 70). Spread is favoured by poor hygienic conditions as in refugee camps. Associated neurological disease (radiculomyelopathy, cranial nerve involvement) occurs rarely and may lead to residual paralysis.
- Coxsackie B has also been associated with idiopathic dilated cardiomyopathy. Some studies have shown evidence for a connection between juvenile diabetes type 1 and coxsackie B virus infection.
Lab Diagnosis:
Virus may be isolated from the pharynx early in the disease, from faeces for at least 1 week and in some cases from other sites of infection. Enterovirus nucleic acid may be detected by PCR in faecal sample, throat swab, vesicle fluid, myocardial tissue, pericardial fluid or in cerebrospinal fluid (CSF) for aseptic meningitis. For antibody investigations the m-capture ELISA is the method of choice.
Complications:
Occasionally neurological sequelae.
Treatment & Prophylaxis:
AMH.
buy viagra without
buy viagra without prescription
Thank you very much for this
Thank you very much for this information.
Good post thanks for sharing.
I like this site ;)
-----------
web tasarım web tasarım
sohbet sohbet odaları
horlama horlama tedavisi
çet çet
sohbet odaları sohbet odaları
mirc mirc
cam balkon cam balkon
otomatik kapı otomatik kapı
-----------
buy viagra without
buy viagra without prescription
Very Useful information ,
Very Useful information , this is both good reading for, have quite a few good key points, and I learn some new stuff from it too, thanks for sharing your information. Buy low and sell high. There is a good source to help your business grow and profitable to buy handbags at wholesale handbags prices from our best designer handbags online stores.
handbags | wholesale handbags | designer handbags
cheap nike shox
Here a wide range of Nike Shox & air shox for both men and women's option. The Nike Shox Sale is best selling online. Get your own Cheap Nike Shox now.You can find the best quality shoes here: Shox R4,Shox NZ,Shox r2,Shox turbo,ect.
http://www.jp-brand-jp.com
Promotional Shoes
販売送料無料ブランドバッグ
Air Jordan 22 (XXII)
Short Christian Louboutin Boots
販売送料無料グッチバッグコピー
Air Jordan 23 (XXIII)
Tall Christian Louboutin Boots
海外有名なブランドバッグ販売送料無料
Air Jordan 3 (III)
YSL Platform Pumps&Slingbacks
海外有名なブランド小物コピー
Air Jordan 4 (IV)
Yves Saint Laurent
販売送料無料ルイヴィトンコピー品
Air Jordan 5 (V)
1K Christian Louboutin Black Alta perla shoes
超人気海外有名なS級ブランドコピー品
Air Jordan 6 (VI)
generic viagra online
generic viagra online
There is pain on swallowing
There is pain on swallowing and usually slight fever of a few days’ duration. Differential diagnoses are herpes simplex, varicella, aphthous stomatitis.
club penguin
very useful
as it comes to the microbiology most of the people around us did not know well about the fact that it is the very important field of our life, even in or at our hand hundreds and thousands of microbiological beings called germs exist and are so dangerous that they can cause deadly virus and viral infection into our body. these work as they are having the backup as huge number like trillions of them on our whole body.