Coxsackievirus

Coxsackievirus refers to a group of enteroviruses within the genus Enterovirus of the family Picornaviridae. They are non-enveloped, positive-sense single-stranded RNA viruses with an icosahedral capsid. The genus includes two species, Coxsackie A and Coxsackie B, comprising many serotypes that collectively cause a variety of human illnesses.

Transmission occurs primarily via the fecal-oral route and can also occur through respiratory droplets or contact with contaminated surfaces. After entry, infection is often local in the oropharynx or gastrointestinal tract, with potential dissemination via the bloodstream. The viruses are found worldwide, with outbreaks more common in children and in warmer months in temperate regions.

Clinical manifestations range from mild to more serious. Hand, foot, and mouth disease and herpangina are the most recognizable illnesses linked to Coxsackie A serotypes. Coxsackie B viruses are associated with febrile illness and more significant disease such as aseptic meningitis, myocarditis, pericarditis, and pleurodynia (Bornholm disease). Neonatal infections and infections in individuals with underlying conditions can occur and may be more severe.

Diagnosis is typically clinical but can be supported by laboratory testing. RT-PCR from throat swabs, stool, or cerebrospinal fluid can detect viral RNA; viral culture and serology are less commonly used. There is no specific antiviral therapy; management is supportive, including hydration, fever and pain control, and oral care for mouth lesions. Prevention centers on good hygiene and avoiding close contact with infected individuals; there is no licensed vaccine for Coxsackie viruses.