Coxsackievirus

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    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.

Quick GuideChildhood Diseases: Measles, Mumps, & More

Childhood Diseases: Measles, Mumps, & More

How do physicians diagnose coxsackievirus infections?

Patients are usually diagnosed by their clinical appearance. Clinically, blisters that are painful usually on the hands, feet, and mouth in a child with fever are considered diagnostic of coxsackievirus infection. However, in rare instances, viral tests can be done to identify the virus, but the tests are expensive, usually need to be sent to a specialized viral diagnostic laboratory that uses RT-PCR, and often take about two weeks to get a result. This testing is almost never done since most infections are self-limited and typically mild, but this situation may change because of an outbreak in Alabama (38 children, 12% hospitalized but no deaths in 2011-2012) and the recent enterovirus 71 epidemic (about 905 of hospitalized children have died) in Cambodia. RT-PCR testing can distinguish between many viral genera, species, and subtypes. Distinguishing coxsackievirus strains from adenoviruses, other enterovirus types, echo virus, viruses causing mononucleosis, and other viral diseases may become necessary in the future.

Is there any treatment for coxsackievirus infection?

There is no specific treatment for this typically self-limited disease (the symptoms resolve without specific antiviral treatment in about two to 10 days). However, symptomatic treatment (acetaminophen [Tylenol]) that reduces fever and discomfort is currently recommended. Mouthwashes and sprays may lessen the oral discomfort. Fluids are also suggested to prevent dehydration, however, acidic juices may irritate the mouth ulcers. Home remedies like cold milk may sooth the oral discomfort. Some physicians use topical diphenhydramine (Benadryl)-containing gel or liquids to treat the hand and foot discomfort.

The relatively rare complications of coxsackievirus infections (for example, heart or brain infection) require special individualized treatments (possibly human immune globulin or specific antivirals, although such treatments are rare and not yet proved to be safe and effective with serious HFMD infections). These treatments are often administered by an infectious-disease doctor.

Medically Reviewed by a Doctor on 10/20/2016

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