Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the signs and symptoms of Coxsackie virus infection?
The most frequent signs and symptoms of Coxsackie viral infections start with fever, sore throat, malaise (feeling tired), and a poor appetite. This incubation period lasts about
one to two days. Sore areas in the mouth develop in about a day or two after the initial fever and develop into small blisters that often ulcerate. Many infected people (usually children 10
years of age and younger) go on to develop a rash that itches on the palms of the hands and the soles of the feet. Other areas such as the buttocks and genitals may be involved. These symptoms usually last about
seven to 10 days and the person recovers completely. The individuals are most contagious for about a week after symptoms begin, but because the virus can be shed by the infected individual sometimes for weeks after the symptoms have gone away, the person may be mildly contagious for several weeks. The last two references show pictures of the blisters.
Infrequently, the infection may result in temporary fingernail or toenail loss (termed onychomadesis). Rarely, the disease may progress to cause viral meningitis (headache, stiff neck), myocarditis (heart muscle infection), pericarditis (inflammation/fluid collection of the tissue surrounding the heart), or encephalitis (brain swelling).
How do people get infected with Coxsackie virus, and what are the risk factors?
Infection usually is spread by fecal-oral contamination, although occasionally the virus is spread by droplets expelled by infected individuals. Items like utensils, diaper-changing tables, and toys that come in contact with body fluids that contain the virus may also transmit them to other individuals. Although people of any age can get infected, the majority of patients identified with Coxsackie infection are children. Pregnant women can pass Coxsackie virus to their newborns, which may cause serious problems for the newborn, so pregnant women need to notify their obstetrician if they exhibit symptoms of the infection, especially if they are near their delivery date.
Risk factors for Coxsackie virus infection include physical contact with any patient with individuals with HFMD symptoms. Infectious virus can be found in feces, saliva, fluid in blisters, and nasal secretions. Even patients
who have recovered and have no symptoms may still shed infectious virus for weeks.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Hand-foot-and-mouth syndrome is clinical pattern consisting of a rash on the hands and feet, and in the mouth. Hand-foot-and-mouth syndrome is caused by various viruses including several types of the coxsackievirus. Other symptoms include sore throat, decreased appetite, irritability, and (or) fever.
Pericarditis is the inflammation of the pericardial sac that surrounds the heart. The causes of pericarditis include injury from heart attack, heart surgery, trauma; viral or fungal infection, HIV, tumors, mixed connective tissue disease, metabolic disease, medication reactions, or idiopathic. Treatment for pericarditis is generally medication, however, sometimes surgery is necessary.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
Septic arthritis, or infectious arthritis, is infection of one or more joints by bacteria, viruses, or fungi. Symptoms and signs of septic arthritis include fever, joint pain, chills, swelling, redness, warmth, and stiffness. Treatment involves antibiotics and the drainage of the infected joint.
Herpangina is a contagious illness often seen in children. It is caused by an enterovirus. Coxsackie virus is the most common cause. Symptoms and signs include mouth sores, fever, and sore throat. Treatment focuses on alleviating fever and pain with acetaminophen and ibuprofen. It is important for children to stay well hydrated, as children may be resistant to eating or drinking.
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