Summary
Coxsackie viruses are a group of RNA viruses with over 20 serotypes; depending on specific viral characteristics, these serotypes are further divided into groups A and B. Infection is associated with a wide range of symptoms, which are dependent on the exact serotype. Hand, foot, and mouth disease (HFMD) and herpangina are commonly caused by group A coxsackie viruses, while pleurodynia and myocarditis are caused by group B coxsackie viruses. Both groups may cause viral meningitis, conjunctivitis, or pneumonia. Diagnostic procedures and treatment should be tailored to the specific disease manifestation.
Epidemiology
- Worldwide distribution
- Occur in all age groups
- Highest incidence in infants and young children (< 10 years) [1]
Epidemiological data refers to the US, unless otherwise specified.
Etiology
-
Pathogen: coxsackie virus
- Genus: enterovirus
- Family: picornaviridae
- Over 20 serotypes, divided into group A and group B coxsackie viruses
- Single‑stranded RNA virus
-
Route of transmission
- Airborne droplets
- Fecal‑oral route
Disease manifestations
Coxsackie A [2]
- Conjunctivitis
- Herpangina
- Hand, foot, and mouth disease
Coxsackie B [2]
- Myocarditis
- Pericarditis
- Dilated cardiomyopathy
-
Pleurodynia [3]
- Characteristics: highly contagious
- Clinical features
- Diagnosis
- Clinical
- Viral culture or PCR (throat or stool sample), serological testing
- Creatine kinase may be elevated [4]
- Treatment: symptomatic
- Prognosis: self‑limiting
Coxsackie A and B
- Viral meningitis, encephalitis
- Pneumonia
Coxsackie B is the most common cause of viral myocarditis.
