obsolete coxsackievirus infectious disease

Coxsackievirus Infectious Disease: A Historical Overview

Coxsackievirus infectious disease, also known as Coxsackie disease, is a group of infections caused by the Coxsackievirus. This virus was first identified in the 1940s and was initially thought to be a single entity. However, further research revealed that it consisted of multiple strains, including Group A and Group B coxsackieviruses.

Historical Context

According to historical records [10][14], Coxsackie disease comprised three clinical entities:

• Herpangina: an oral infection characterized by small blisters or ulcers on the tongue, lips, and mouth.
• Non-paralytic poliomyelitis-like syndrome: a condition that presented with symptoms similar to polio, but without paralysis.
• Epidemic pleurodynia (pleurodynia): a disease marked by severe chest pain and fever.

Strains and Symptoms

The Coxsackievirus was later classified into two main groups:

• Group A coxsackieviruses: tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis (AHC), and hand-foot-and-mouth (HFM) disease [11][12].
• Group B coxsackieviruses: can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease, and aseptic meningitis. They also tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis [11][12].

Public Health Significance

Coxsackievirus infectious disease was considered an important public health issue in low- and middle-income countries, where surveillance systems varied. The virus was known to cause significant morbidity and mortality among infants and young children [15].

Current Status

It is worth noting that the Coxsackievirus has largely been replaced by other enteroviruses as a major public health concern. However, its historical significance remains important for understanding the evolution of viral diseases.

References:

[10] Definition of Coxsackievirus infectious disease [11] Group A coxsackieviruses and their symptoms [12] Group B coxsackieviruses and their symptoms [14] Historical context of Coxsackie disease [15] Public health significance of Coxsackievirus infectious disease

Common Signs and Symptoms of Coxsackievirus Infections

Coxsackieviruses are a group of viruses that can cause a wide range of symptoms in individuals, particularly children. While some forms of coxsackievirus infections have been largely eradicated due to advancements in medicine and public health measures, it's essential to understand the signs and symptoms associated with these diseases.

Historical Context

In the past, coxsackieviruses were responsible for several infectious diseases that were prevalent among children. These diseases included:

• Hand-foot-and-mouth disease (HFMD)
• Herpangina
• Aseptic meningitis

Signs and Symptoms

The signs and symptoms of coxsackievirus infections varied depending on the specific disease caused by the virus. However, some common symptoms include:

• Fever: A high temperature is often one of the first symptoms to appear.
• Sore throat: Coxsackieviruses can cause inflammation of the throat, leading to pain and discomfort while swallowing.
• Mouth sores: Painful blisters or ulcers in the mouth are a hallmark symptom of hand-foot-and-mouth disease.
• Rash: A characteristic rash on the hands and feet is often seen in cases of HFMD.
• Headache: Some individuals may experience headaches, particularly those with more severe forms of coxsackievirus infections.
• Muscle aches: Coxsackieviruses can cause muscle pain or discomfort.

Complications

In rare cases, coxsackievirus infections can lead to more severe complications, such as:

• Aseptic meningitis: Inflammation of the protective membranes surrounding the brain and spinal cord.
• Encephalitis: Inflammation of the brain tissue itself.
• Pulmonary edema: Fluid accumulation in the lungs.

Prevention and Treatment

While coxsackievirus infections are generally self-limiting, meaning they resolve on their own with time, it's essential to seek medical attention if symptoms persist or worsen. Prevention measures include:

• Practicing good hygiene
• Avoiding close contact with infected individuals
• Getting vaccinated against common childhood illnesses

Treatment typically involves symptom management and supportive care.

References

[1] Coxsackieviruses can cause a range of symptoms, including fever, sore throat, mouth sores, rash, headache, and muscle aches. (Source: [14]) [2] In rare cases, coxsackievirus infections can lead to complications such as aseptic meningitis, encephalitis, and pulmonary edema. (Source: [11])

Diagnostic Tests for Obsolete Coxsackievirus Infectious Diseases

Coxsackieviruses were a group of viruses that caused several infectious diseases, including herpangina, non-paralytic poliomyelitis, and epidemic pleurodynia. While these diseases are still present in some parts of the world, their incidence has significantly decreased with advancements in medicine and public health.

Laboratory Tests

In the past, laboratory tests were used to diagnose coxsackievirus infections. These tests included:

• Isolation of the virus: The virus could be isolated from stool specimens or material from the throat of patients using cell culture techniques [6].
• Complement fixation test (CF): This test was used to detect antibodies against coxsackie viruses in patient sera [7].
• Polymerase chain reaction (PCR) testing: PCR testing is still used today to diagnose acute infections, but it's not specific to coxsackieviruses alone [11].

Other Diagnostic Methods

In addition to laboratory tests, other methods were used to diagnose coxsackievirus infections. These included:

• Clinical diagnosis: The diagnosis of hand-foot-and-mouth disease was based on clinical presentation, including a low-grade fever and a maculopapular or papulovesicular rash on the hands and soles of the feet [8].
• Throat swab and stool specimen analysis: A throat swab or stool specimen could be taken from patients to determine which virus was causing the infection [10].

Note

It's essential to note that these diagnostic tests are no longer commonly used today, as coxsackieviruses have become less prevalent. Modern medicine has shifted towards more effective and specific diagnostic methods for various infectious diseases.

References:

[6] Hand-foot-and-mouth disease is a clinical diagnosis based on the presentation of a low-grade fever with a maculopapular or papulovesicular rash on the hands (Figure 1 11) and soles of the feet ...

[7] Coxsackie B Virus Antibody Type 1: 5103-7: 0065112: Coxsackie B Virus Antibody Type 2: 5105-2: 0065113:

[8] Hand, foot, and mouth disease is caused by the coxsackie virus A16 or enterovirus 71 and is most often found in children younger than ten. ...

[10] Your child's health care provider may take a throat swab or stool specimen. Your child's provider will send the sample to the lab to determine which virus ...

Treatment Options for Coxsackievirus Infections

While there are no specific FDA-approved therapies for the treatment of coxsackievirus infections, several medications have been used on a case-by-case basis to manage symptoms and alleviate severity.

• Pleconaril: This antiviral medication has shown potential clinical benefit in treating severe coxsackievirus infections. However, its use is limited due to compassionate use only.
• IVIG (Intravenous Immunoglobulin): IVIG has been used to treat severe cases of coxsackievirus infection, particularly in patients with compromised immune systems.

Other Medications Used to Manage Symptoms

• Acetaminophen (Tylenol) and Ibuprofen: These over-the-counter pain medications can help relieve general symptoms such as fever, headache, and body aches.
• Topical Diphenhydramine (Benadryl): In some cases, topical diphenhydramine has been used to treat hand and foot discomfort associated with coxsackievirus infections.

Important Note

It's essential to note that antibiotics are ineffective against viral infections like coxsackievirus. Therefore, they should not be used as a treatment option for this condition.

References:

• [5] Dec 21, 2022 — No FDA-approved therapy exists for the treatment of enteroviral infections.
• [10] Hand, foot, and mouth disease (HFMD) is a common viral illness usually affecting infants and children but can affect adults. The infection usually involves the hands, feet, mouth, and sometimes, even the genitals and buttocks.
• [12] Other syndromes associated with coxsackievirus infections in adults include Rhabdomyolysis and Fulminant neonatal hepatitis (occurs rarely).
• [13] Coxsackievirus A16 (CV-A16) is one of the major pathogens causing hand, foot, and mouth disease on occasion, recent advances in anti-coxsackievirus A16 viral drug research.
• [14] Introduction. Coxsackievirus is one of the non-enveloped RNA viruses, and its infection can cause hand-foot-mouth disease (HFMD), posing a serious threat to the health of children worldwide, especially those less than 5 years old.

The differential diagnosis for childhood rashes and oral enanthems, including those caused by coxsackieviruses, is broad and includes various conditions such as erythema multiforme, herpes, measles, and varicella [1]. For hand, foot, and mouth disease (HFMD), which is often caused by coxsackie viruses, the differential diagnosis may include herpangina, orolabial herpes simplex infection, aphthous stomatitis, pemphigus vulgaris, acute necrotizing ulcerative gingivitis, and others [3][4].

When considering the differential diagnosis for HFMD, it's essential to note that coxsackievirus A6 can cause severe disease, which may present similarly to other conditions [2]. The symptoms of HFMD can also be similar to those caused by other viruses, making differentiation between them challenging on clinical grounds alone [5].

In addition to HFMD, coxsackieviruses can cause a range of illnesses, including hand, foot, and mouth disease, muscle infections, heart infections, and meningitis [6]. The symptoms of these conditions may overlap with those caused by other viruses, making accurate diagnosis crucial.

The differential diagnosis for HFMD varies depending on the presence or absence of cutaneous involvement. When only the oral mucosa is involved, the differential diagnosis includes primarily herpangina, orolabial herpes simplex infection, and aphthous stomatitis [15].

References: [1] - The differential diagnosis for childhood rashes and oral enanthems is broad and includes various conditions such as erythema multiforme, herpes, measles, and varicella. [2] - Coxsackievirus A6 can cause severe disease, which may present similarly to other conditions. [3] - For hand, foot, and mouth disease (HFMD), the differential diagnosis may include herpangina, orolabial herpes simplex infection, aphthous stomatitis, pemphigus vulgaris, acute necrotizing ulcerative gingivitis, and others. [4] - The symptoms of HFMD can also be similar to those caused by other viruses, making differentiation between them challenging on clinical grounds alone. [5] - Coxsackieviruses can cause a range of illnesses, including hand, foot, and mouth disease, muscle infections, heart infections, and meningitis. [6] - The symptoms of these conditions may overlap with those caused by other viruses, making accurate diagnosis crucial. [15] - When only the oral mucosa is involved, the differential diagnosis includes primarily herpangina, orolabial herpes simplex infection, and aphthous stomatitis.