Coxsackie virus infection B34.1

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Infection with Coxsackie viruses, which can cause the following diseases, among others:

A trigger of dermatomyositis by Coxsackie virus infections is also being discussed.

Clinical features
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Diagnosis
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  • Laboratory diagnostics in the newborn/infant: Coxsackievirus PCR or ELISA from CSF, serum, throat swab or stool samples.
  • To confirm infection in the mother: Coxsackievirus PCR or ELISA from maternal blood and stool samples and in the case of delivery from cord blood.

Complication(s)
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  • In case of infections with Coxsackie echoviruses in the first and second trimenon: Only exceptionally have infantile malformations (CNS, cardiovascular, gastroenteral, urogenital) been described. In case of high fever, abortion or intrauterine death may occasionally occur. The risk of infantile damage at birth is in the range of the so-called normal risk of +/- 3.5%. There is no evidence for an association of maternal enterovirus infection and fetal/infantile malformations or developmental disorders.
  • Maternal infection at the end of the third trimester: In newborns born to mothers with acute infection shortly before delivery, severe neonatal diseases may occur: sepsis, meningoencephalitis, myocarditis, hepatitis, coagulopathy.
  • In the case of intrauterine transmitted infections, the course of the disease is usually severe, but in the case of early postpartum infection (e.g. through visitor contact or in the neonatal ward) the symptoms are less severe.
  • STAR complex: arthritis recurring for months, fever attacks, sore throat and maculo-papular exanthema.

Therapy
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  • A special antiretroviral therapy is not yet available. Successes ( off-label use!) with Pleconaril (viral static, effective against rhinoviruses) have been described in individual case reports.
  • The value of IVIG therapy, e.g. with Intratect, for newborns and for contact children or persons, as recommended so far, has not been proven.
  • Measures to limit infection: Maternity unit/neonatalogy point out possible maternal infection. Good hygiene measures are important. Rooming-in of mother with child.

Literature
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  1. Ashbourne Excoffon KJ et al (2003) The coxsackie B virus and adenovirus receptor resides in a distinct membrane microdomain. J Virol 77: 2559-2567
  2. Bauer S et al (2002) Severe Coxsackie virus B infection in preterm newborns treated with pleconaril. Eur J Pediatr 161: 491-493
  3. Centers for Disease Control and Prevention (CDC) (2008) Increased detections and severe neonatal disease associated with coxsackievirus B1 infection--United States, 2007 MMWR Morb Mortal Wkly Rep 57: 553-556
  4. Crocker SJ et al (2007) Amelioration of coxsackievirus B3-mediated myocarditis by inhibition of tissue inhibitors of matrix metalloproteinase-1 Am J Pathol 171:1762-1773
  5. Foster HD (2002) Coxsackie B virus and myocardial infarction. Lancet 359: 804
  6. Hengstman GJ et al (2002) Clinical and serological characteristics of 125 Dutch myositis patients. Myositis specific autoantibodies aid in the differential diagnosis of the idiopathic inflammatory myopathies. J Neurol 249: 69-75
  7. Theodoridou M et al (2002) Vesiculopapular rash as a single presentation in intrauterine coxsackie virus infection. Eur J Pediatr 161: 412-413
  8. Utzig N et al (2003) Polio-like myelitis due to Coxsackie virus B 3: Course Under Treatment with Pleconaril. Clin Padiatr 215: 286-287

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020