The incubation period of Coxsackie virus infection ranges from 2 to 9 days. The clinical manifestations of various coxsackievirus infections are diverse and may exist as entities of different diseases.
A. Helpandina
This disease is caused by certain group A viruses (2, 4, 5, 6, 8, 10). Fever, sore throat, loss of appetite, swallowing disorder, vomiting or abdominal pain occurs suddenly. The pharynx is usually hyperemic, characteristic distinct vesicles occur on the serous, palate, uvula, tonsil or the anterior pillar of the tongue. Illness is self limiting and occurs most frequently in children.
B. Mild illness in the summer
Coxsackie virus is an isolated patient with short term acute febrile illness, occurs in summer or autumn, and often has no characteristic features.
C. Pleurodinia (epidemic muscle pain, Borholm disease)
This illness is caused by the B group virus. Fever and chest pain usually develop suddenly, but fatigue, headache, anorexia may precede. Pain in the chest is located on both sides or beneath the sternum and may become more intense with movement and may last from 2 days to 2 weeks. Abdominal pain occurs in about half of cases, which may be a major complaint in children. Disease is self limiting and recovery is complete but recurrence is common.
D. Sterile meningitis and mild paralysis
This syndrome is caused by all types of group B coxsackie virus and Coxsackie viruses A7, A9 and A24. Fever, malaise, headache, nausea, abdominal pain are common early symptoms. Symptoms of meningeal irritation, neck, back pain, and vomiting may appear after 1-2 days. This disease may progress to mild muscle weakness suggestive of paralytic paralysis. The patient almost always recovers completely with paralysis other than poliovirus. Early in aseptic meningitis, cerebrospinal fluid shows pleural adhesions (max. 500 cells / mcL) with up to 50% polymorphonuclear neutrophils.
E. Neonatal disease
Neonatal illness can be caused by vomiting with or without coxsackievirus of group B, eating disorders and fever with lethargy. In severe cases, myocarditis or pericarditis can occur within 8 days after birth. There is a possibility that an episode of short-term diarrhea and anorexia may precede. The embarrassment of the heart and respiratory tract is fatal, and the patient may recover completely. This disease may sometimes be obtained percutaneously. Myocarditis is also caused by several group A coxsackieviruses.
F. Colds
Many intestinal viruses are associated with colds. Among these are Coxsackieviruses A10, A21, A24 and B3.
G. Diseases of hands, feet and mouth
This disease was particularly related to coxsackievirus A16, but A4, A5, A7, A9 and A10 are also relevant. The virus can be recovered not only from feces and pharyngeal secretions, but also from vesicular fluids. Syndrome is characterized by oral and pharyngeal ulceration and limb erosion and feet that may spread over the arms and legs. Vesicles heal without clinical distinctions from herpes and poxvirus vesicles clinically. Rare death is due to pneumonia.
H. cardiomyopathy
Group A coxsackieviruses and echoviruses are involved to a lesser extent. At necropsy, viral infection triggers heart disease. Viruses can affect the endocardium, pericardium, myocardium, or all three. Acute cardiomyopathy has been shown to be caused by coxsackieviruses A4, A14, B1-B5, etc., as well as echoviruses 9 and 22 and the like. Monkeys infected with Coxsackievirus B4 develop pancreatitis with a pathological image that is remarkably similar to the pathological image of lymphatic heart disease. In laboratory animals, the severity of acute viral cardiomyopathy is greatly increased by vigorous exercise, hydrocortisone, alcohol intake, pregnancy and malnutrition, greater in males than females. In human diseases, these factors can likewise increase the severity of the disease.
I. Acute hemorrhagic conjunctivitis
Coxsackie virus A24 is one of the agents that can cause this disease
J. Diabetes
Serologic studies suggest an association of past infection with Coxsackievirus B4 and possibly other members of Group B with sudden diabetes. Experimental studies support findings in human diseases. These factors may likewise increase the severity of the disease.
K. Swine bullous disease
The drug of this disease is enterovirus which is antigenically related to coxsackievirus B5. In addition, porcine virus can infect humans.
