Coxsackie Virus - Symptoms

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What are coxsackie virus infection signs and symptoms?

The most frequent signs and symptoms of coxsackie viral infections are initially fever, a poor appetite, and respiratory illness, including sore throat, cough, and malaise (feeling tired). 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. Some patients develop conjunctivitis. These symptoms usually last about seven to 10 days, and the person usually 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.

Picture of characteristic mouth sores of hand foot and mouth disease
Picture of characteristic mouth sores of hand, foot, and mouth disease (HFMD)
Picture of characteristic rash and blisters of hand foot and mouth disease
Picture of characteristic rash and blisters of hand, foot, and mouth disease (HFMD)

Infrequently, the infection may result in temporary fingernail or toenail loss (termed onychomadesis) and chest or abdominal muscle pain. 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 inflammation).

Infection with EV-71 results in a higher incidence of neurologic involvement with symptoms such as a polio-like syndrome, meningitis, encephalitis, Guillain-Barré syndrome, and/or ataxia.

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Comment from: erich, 55-64 Male (Patient) Published: February 23

With Coxsackie virus infection I had fever for 24 hours. Then onset of blisters on hands, front and back and some blisters on face, and in my case, none on feet. The blisters itch and seem to spread easily.

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Comment from: williamj, 35-44 Male (Patient) Published: May 12

My son's preschool had a Coxsackie virus outbreak of which he ended up getting a mild case. A week after my son's initial symptoms I developed a 101.5 fever, sore throat and generalized body aches. The following day the fever was down but I still had the sore throat and the dorsal and palmar aspect of my hands were extremely itchy but I had no visible rash. The next day I had developed sores around my hand, in my nose, ears and mouth. My palmar and dorsal aspects of my feet had developed a significant rash. It was very painful to extend my fingers and painful to walk on, almost as if I has small rocks in my shoes. Today I have a full body rash, some of which is indurated. I am currently afebrile, but that could be from the Motrin. My throat is still sore as if I swallowed glass and my finger tips are so sore it is painful to even type this. They feel as if my finger nails are under pressure and are going to pop off at any moment. The rash is intermittently itchy. I saw a doctor today, mainly for a work note. I've been living on Motrin 800 mg 3 times/day and Benadryl 50mg 4 times/day. The rash has showed no sign of subsiding, if anything it is worse. The doctor indicated it will have to run its course and to continue conservative treatment. I'm initiating acyclovir 400 mg 3 times/day in addition to Motrin and Benadryl. I realize that it might be too late to start the anti-viral medication but at this point I'm willing to try. This has been a very miserable experience.

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