Enteroviral diseases are a huge group of infections with a predominantly fecal-oral transmission mechanism. A characteristic feature of enterovirus infection is the clinical polymorphism of manifestations.
Outbreaks of diseases are most often observed in the summer-autumn period, although they can be recorded throughout the year.
This article on estet-portal.com describes the typical clinical symptoms of enterovirus infection (with the exception of poliomyelitis), as well as the principles of diagnosis and treatment of the disease.
Etiology and typical clinical symptoms of enterovirus infection
Pathogens that can replicate in human cell cultures and cause enterovirus infection in humans include Polioviruses, group A coxsackieviruses (types 1-22, 24), B (type 1-6), and ECHO viruses (type 1-9, 11-27, 29-34). Recently, new types of enteroviruses have also been discovered that cause infection in humans.
They are grouped under the "unclassified human enteroviruses type 68-71". It should be emphasized that the hepatitis A virus is also an enterovirus, namely its 72nd type.
As mentioned above, enterovirus infection has a characteristic clinical polymorphism.
For pathogens that cause the development of enterovirus infection, polytropism is characteristic, which leads to a variety of clinical manifestations of the disease.
Typical symptoms of an enterovirus infection include:
1. Hand-foot-and-mouth disease (syndrome «hand—leg—mouth»): characteristic rashes in the form of vesicles and spots on the hands (including the palms), legs (including on the feet) and mucous membranes of the oral cavity, fever (may be absent), sore throat and enanthema;
2. Diarrhea, rarely – hepatitis;
3. Cough, hoarseness: To some extent, an enterovirus infection can resemble the flu, which is why it even got the name "summer flu".
For more information on the clinical manifestations of influenza, see the article: Types of influenza viruses and the main clinical symptoms of the disease;
4. Stomatitis, pharyngitis, herpangina;
Thus, the totality of symptoms: diarrhea, catarrhal syndrome, fever (may be absent) and exanthema against the background of a satisfactory condition of the patient can most likely indicate an enterovirus infection.
Enterovirus infection can also lead to the development of more serious pathological conditions, among which it is necessary to highlight:
1. Pleurodynia – the only form of enterovirus infection that occurs predominantly in the adult population. A characteristic symptom – pain of a prickly or compressive nature, which occurs suddenly and is associated with a direct lesion of the muscle virus. The pain attack lasts about 5-10 minutes. Most often, the pain is localized in the chest at the level of the diaphragm, epigastrium and limbs. Fever up to 7 days is typical. Forecast – favorable, the total duration of the disease is about three weeks, although relapses are possible;
2. Myopericarditis: Cardiac involvement is often preceded by a respiratory syndrome. Shortness of breath, fever, chest pains are characteristic, in some cases a heart attack-like syndrome may even appear. As a rule, the symptoms subside after two weeks from the onset, after which recovery occurs. In rare cases, the disease can drag on for up to several months or even become chronic;
3. Aseptic meningitis, rarely encephalitis and/or paralysis resembling poliomyelitis: headache is the leading symptom, meningeal signs are objectively determined. An important point is the lumbar puncture, since in the case of enteroviral meningitis it will have not only diagnostic, but also therapeutic value. In adults, the disease is much milder than in children.
Follow us on Telegram
However, in most cases, enterovirus infection does not lead to a significant deterioration in the patient's condition and proceeds in a mild form. More severe forms of the disease are more common in children.
Differential and specific diagnosis of enterovirus infection
Quite often, the only manifestation of an enterovirus infection is exanthema in the form of papules and vesicles. Such a clinical picture of the disease can mislead clinicians regarding other infections that occur with exanthema: measles, chicken pox, yersiniosis, herpes virus infection.
In such cases, the doctor should be guided by the absence of pathognomonic symptoms of these diseases: Koplik's spots in measles, the "hood, gloves and socks" symptom; in pseudotuberculosis, fake polymorphism in chicken pox, and so on.
Read also: Diagnosis and treatment of yersiniosis: how to prevent complications
The diagnosis of enterovirus infection can be finally confirmed by examining the patient's blood for the presence of Enterovirus RNA by PCR.
In the case of a typical clinical picture of the disease, special research methods are not appropriate.
Key aspects of treatment of enteroviral infection: a modern view
Enterovirus infection is a self-limiting disease: in most cases, recovery occurs spontaneously without any medical treatment. There is no etiotropic therapy for enterovirus infection.
There is no etiotropic therapy for enterovirus infection.
Treatment for enterovirus infection includes bed rest for fever, rest, and proper nutrition.
Therapy of enteroviral meningitis – pathogenetic: decongestant, anticonvulsant, sedative (if indicated).
If water and electrolyte disturbances develop against the background of enteroviral diarrhea, they should be corrected by infusion of saline solutions.
Follow us on Telegram
The treatment of enteroviral myocarditis today is associated with some difficulties. The feasibility of using glucocorticoids is still a controversial issue. Against the background of myocarditis, different types of arrhythmias may occur, which require a differentiated approach to prescribing therapy. Thus, enteroviral myocarditis – disease, the treatment of which should be carried out under the supervision of cardiologists and infectious disease specialists.
Since the most common mechanism of transmission of enterovirus infection is fecal-oral, personal hygiene is an important point in preventing the development of the disease.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Infectology" section. You might also be interested in: Red gloves, socks and hood: clinical manifestations of pseudotuberculosis.
Share:
Add a comment