Coxsackie in Adults

Coxsackie virus infection is more common in children and most commonly causes hand, foot and mouth disease. However, coxsackie infection can also occur in adults and cause numerous diseases. Symptoms of Coxsackie in adults are various due to different causes.

Coxsackie is not a single virus but a group of viruses collectively referred to as Coxsackie viruses. There are approximately ~29 different viruses that are classified as "coxsackie". The Type A Coxsackie virus commonly causes the hand, foot and mouth disease and the Type B group usually causes more serious conditions. There are numerous disease conditions that can be caused by coxsackie viruses and they are listed below.

Conditions Caused by Coxsackie

Symptomatic Coxsackie virus infection most commonly results in a nonspecific illness with fever. Asymptomatic Coxsackie virus infection can also occur and together with nonspecific febrile illness, they constitute nearly 9 out of 10 cases of coxsackie virus infection.

Less commonly, Coxsackie virus infection can result in more severe disease conditions like meningitis, encephalitis, paralysis, myocarditis, pericarditis, diabetes, rash conditions (hand, foot and mouth disease), etc.

Table: Conditions Caused by Coxsackie Virus Infection

Conditions

Symptoms

Meningitis

Inflammation of the meninges covering the brain.

Symptoms: Fever, chills, headache, nausea and vomiting, neck pain, photophobia, seizures etc.

Encephalitis

Inflammation of the brain.

Uncommon manifestation of Coxsackie virus infection.

Symptoms: Symptoms of meningitis + variable neurological symptoms.

Paralysis

Rarely, coxsackie virus infection can result in paralysis. Usually, the paralysis resolves with time.

Pericarditis

Inflammation of the sac covering the heart.

Symptoms: Sharp chest pain, shortness of breath, fever, weakness, swelling in feet, etc.

Myocarditis

Inflammation of the heart muscles.

Can result in heart failure and death.

Symptoms: Shortness of breath, chest pain, poor exercise tolerance, fever, swelling in feet, etc.

Type 1 Diabetes

Coxsackie virus is believed to cause some cases of Type 1 Diabetes (insulin dependent diabetes mellitus that occurs more commonly in younger age group).

Coxsackie virus infection damages insulin producing cells of the pancreas resulting in diabetes mellitus.

Hand, Foot and Mouth Disease

Occurs more commonly in children, but can also occur in adults.

Symptoms: Sore throat, fever, rashes followed by vesicular eruptions in foot and hand that later ulcerate.  

Herpangina

Occurs commonly in children between ages of 3-10 years. Rare in adults.

Symptoms:  Fever, headache, sore throat, painful swallowing, ulcers in mouth and throat.

Pleurodynia

Inflammation of chest muscles resulting in sudden pain in chest and upper abdomen.

Hemorrhagic Conjunctivitis

Inflammation of the conjunctiva of the eye.

Symptoms: Pain and swelling of the eyelids, red eye, headache.

Hepatitis

Inflammation of the liver.

Symptoms: Fever, anorexia, malaise, jaundice, nausea and vomiting, weakness, etc.

Coxsackie Virus Infection and Immunosuppression

Coxsackie virus infection is more likely in conditions resulting in immune system dysfunction. Moreover, the symptoms are more severe and last longer in immunosuppressed individuals. Immune system dysfunction can occur in long standing diabetes mellitus, organ transplant recipients, AIDS, anti-cancer chemotherapy, cancers, etc.  

Treatment for Coxsackie Virus Infection

Treatment is mainly symptomatic and supportive. No specific drug is available that is effective against Coxsackie virus infection. One should maintain adequate personal hygiene (washing hands with soap and water after defecation, frequent washing of hands, etc.) to minimize the chances of spread of infection to other people. Dehydration should be avoided by drinking plenty of water. Other treatment depends upon the symptoms (pain killers for pain, saline gargles with lukewarm water for sore throat, drugs like acetaminophen for fever, etc.)

Prevention of Coxsackie Virus Infection

They commonly spread because of ingestion of contaminated food or water. They might also spread by respiratory droplets. So maintaining proper personal hygiene is of paramount importance. Hands should be washed frequently by both the infected and normal people. Personal items should not be shared. Steps should be taken to maintain cleanliness in the house. Fecal contaminated waste of baby use (diapers etc.) should be properly disposed off.


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