Coxsackievirus treatment in children. How a child can become infected: causes of the disease. Symptoms of intoxication with the Coxsackie virus

Infection of people with the Coxsackie virus most often occurs in childhood. They penetrate any organ, so the manifestations of infection are extremely varied, and complications can be very severe. Seasonal outbreaks of diseases are often observed. In the middle of the last century, a massive infection of people occurred in the American town of Coxsackie; it was found that this particular pathogen was the culprit of the epidemic. That's why they called him that. Children are usually treated at home, but complications require hospitalization.

Content:

Characteristics of the Coxsackie virus

This microorganism belongs to enteroviruses, that is, it multiplies in the intestines, from where it enters other organs, causing their inflammation. Human infection with the Coxsackie virus usually occurs in childhood, under the age of 5 years. Infants under 3 months of age who still have maternal immune cells in their bodies are not infected. The exception is babies infected with the Coxsackie virus in the womb.

If children are breastfed, their immunity remains intact until they are completely switched to regular food.

There are 2 main groups of Coxsackie viruses.

Group A pathogens are found most often in children. The infection has typical manifestations and does not cause severe complications. Possibly asymptomatic.

Coxsackie viruses group B are much less common. In this case, a characteristic feature is the atypical course of the infectious process with severe and dangerous complications. If a pregnant woman becomes infected with similar Coxsackie viruses, the child’s health may also suffer.

The Coxsackie virus is found in the patient's feces. With sewage, microbes enter the soil and natural bodies of water. Harmful microorganisms may end up on toys and things that a sick baby has touched. They do not die when cleaning hands with disinfectant wipes. Under normal environmental conditions, Coxsackie viruses are viable for many days.

They can withstand freezing down to -70°. Viruses of this type enter into suspended animation and can exist in this state for years, remaining active after thawing. Coxsackie viruses are not sensitive to the effects of alcohols, acids and other substances usually included in disinfectants. They only die in bleach and formaldehyde.

At the same time, microbes cannot tolerate exposure to ultraviolet rays and sunlight. They die within half an hour at a temperature of 60°. At 100° this happens instantly. A humid environment favors the multiplication of Coxsackie viruses. They die in dry and hot air.

Due to the fact that it is extremely easy to become infected with the Coxsackie virus, outbreaks of diseases often occur, especially in children's groups. Moreover, this is most often observed from mid-summer to the end of October. At risk of infection are children with weakened immune systems (for example, patients with HIV), as well as those born prematurely, with poor physical development, and living in unsanitary conditions.

How dangerous is the virus for children?

As a result of infection with the Coxsackie virus, the baby becomes dangerously dehydrated due to diarrhea and vomiting. It leads to a decrease in the total volume of blood and a change in its consistency. Possible manifestations of anemia.

Severe complications of Coxsackie virus infection include pulmonary edema, inflammation of the heart muscle, encephalitis, poliomyelitis, and diabetes mellitus. In utero infection with the Coxsackie virus group B, the death of a newborn baby can occur.

Causes and routes of infection with the Coxsackie virus

One of the main reasons a child becomes infected is direct contact with a sick person or communication with a virus carrier. Carriers of the Coxsackie virus are people who have already had the disease and who remain contagious for some time after the symptoms disappear. Viruses are stored in their feces, urine, saliva, from where they are transferred to various objects.

It is possible that infection can enter the body from the environment (for example, from the water of natural reservoirs, from the surface of poorly washed vegetables and fruits).

There are the following ways of infection with the Coxsackie virus:

oral-fecal (particles of contaminated soil or pond water entering the baby’s mouth);
contact-household (infection through toys, dishes, things and objects that may contain Coxsackie viruses);
airborne (viruses enter the nasopharynx from the air, where they appear as a result of a patient sneezing or coughing);
transplacental (intrauterine infection).

First of all, Coxsackie viruses penetrate the intestines and lymph nodes, from where they enter the muscles (including the myocardium - heart muscle), into the deep layers of the skin, and into the brain. They penetrate the mucous membranes of the nasopharynx, eyes, intestines, and affect the liver.

Video: How to become infected with the Coxsackie virus. Possible manifestations

Manifestations of enterovirus infection Coxsackie

Enterovirus infection Coxsackie can manifest itself in a typical and atypical form.

Typical diseases The diseases that arise as a result of infection of children with the Coxsackie virus are herpangina, myalgia, enteroviral exanthema, and serous meningitis.

Atypical form. Characteristic manifestations are encephalitis, poliomyelitis, gastroenteritis, catarrh of the upper respiratory tract, diseases of the heart, eyes, and genitourinary organs. Often with this form the symptoms are smoothed out.

Manifestations can be mild, moderate and severe. The disease occurs in a complicated or uncomplicated form. With uncomplicated course it lasts 3-10 days. It manifests itself mainly as diarrhea, skin rashes, and fever. For complicated form Characterized by severe damage by viruses to the nervous system, brain, heart and other organs.

Options for the development of the disease are as follows:

complete recovery, death of all Coxsackie viruses in the body;
transition of diseases of individual organs into a chronic form;
partial persistence of viruses for several weeks after recovery (virus carriage).

Note: Stable immunity to the Coxsackie virus is not developed, since viruses of this type are constantly mutating. A person can get sick again at any age, but the disease in this case is mild.

Signs of infection with Coxsackie viruses

The first symptoms of infection with the Coxsackie virus are an increase in temperature to 39°-40°, enlargement of the axillary and cervical lymph nodes, as well as nausea, vomiting and diarrhea. External signs of the baby’s illness include lethargy and drowsiness, redness of the face, and the formation of a white coating on the tongue. Blistering rashes appear (as with chickenpox), causing itching. They are localized on the fingers and palms, on the feet, on the chest, around the mouth, as well as in the oral cavity and tonsils. After the blisters burst, ulcers remain.

Children lose their appetite. Young children refuse to breastfeed. There is an enlargement of the liver and spleen, and an acceleration of the heartbeat.

Features of the course of the disease

The incubation period for infection with viruses is usually 2-10 days. There are 3 stages of disease development:

Elementary. Acute manifestation of symptoms of organ inflammation and intoxication of the body.
Period of appearance of rashes. It begins 2 days after the onset of the first ailments. Due to a rash in the mouth, the child cannot eat normally and his drooling increases. During the same period, symptoms of intestinal virus damage appear, such as bloating, loose stools, possibly mixed with pus and blood.
Fading of symptoms. If the disease is not complicated by suppuration of the ulcers, then the signs of infection of children with the Coxsackie virus quickly disappear.

The course of the disease can be “smooth” when the manifestations develop sequentially and disappear after a maximum of 3 weeks. A “wave-like” course of the disease is possible, in which the symptoms either intensify or weaken. In the chronic form of the disease, they speak of a “recurrent” course.

Isolated form– this is a virus attack on any individual organ. Combined form occurs when various organs are simultaneously damaged.

Types of possible diseases

The development of the disease and the nature of complications depend on which organs are most affected, as well as on the type of Coxsackie virus that has entered the body.

Enteroviral fever. This is the mildest manifestation of the infection, reminiscent of acute respiratory infections in its symptoms. The child has a high temperature and is bothered by muscle aches. The malaise lasts for 3-4 days (which is why the disease is also called “three-day fever”), then all symptoms disappear without a trace.

Enteroviral stomatitis with exanthema. A characteristic sign is the appearance of profuse rashes in the mouth, around the lips, on the face and on the limbs. The disease is also called hand-foot-mouth syndrome. Unlike rubella or chickenpox, exanthema goes away in about 5 days, and the rash disappears. As a rule, there are no consequences.

One of the common complications that appears 2-8 weeks after recovery is layering of the nail plates on the fingers and toes. The peeled nail “comes off” completely. Subsequently, a new one grows, without signs of disease.

Note: Many virologists believe that this is not a consequence of the exanthema itself, but the destruction of nails occurs due to weakened immunity and the occurrence of vitamin deficiency. Perhaps, against the background of a previously suffered exanthema, a fungal infection occurs.

Herpangina. This disease is associated with damage to the mucous membranes of the nasopharynx by the Coxsackie virus. With herpangina, the tonsils, tongue and the entire oral cavity become covered with blisters containing liquid contents. The disease is more similar to stomatitis than to a sore throat. Symptoms (high fever, headache, runny nose, swollen lymph nodes, mucosal erosion) disappear after about 8-10 days.

Enteroviral conjunctivitis. This disease has a short incubation period. Already 2 days after infection, pain in the eyes, photophobia, lacrimation, redness of the whites, and discharge of pus appear. At first, only one eye hurts, but the second one is quickly affected. Conjunctivitis is observed for 2 weeks. With effective treatment, the disease goes away without a trace.

Intestinal infection. Common manifestations are frequent diarrhea (up to 8 times a day). The feces are dark. Vomiting and fever are observed. Young children also develop a runny nose, redness and sore throat.

If the baby is not yet 2 years old, he may develop a complication such as milk intolerance due to a lack of lactase. This enzyme breaks down milk sugar. Intestinal damage by the Coxsackie virus disrupts the production of lactase. Consumption of regular milk and dairy products causes diarrhea, dehydration and exhaustion in the child. Therefore, it can only be fed with special foods that do not contain milk sugar. He needs to be given tablets to maintain the enzyme levels in his body.

Hepatitis. One of the symptoms of complications when infected with the Coxsackie virus is inflammation of the liver, which is accompanied by its enlargement and the appearance of a feeling of heaviness and pain in the right hypochondrium. The temperature rises, nausea and heartburn occur.

Pleurodynia (myositis). The disease develops due to viral infection of the muscles. They experience pain of a spasmodic nature. If the intercostal muscles are affected, it is difficult for the baby to breathe. The pain is especially severe when moving.

Infection with manifestations of polio. In addition to fever, diarrhea and rash, the child experiences paralysis of individual muscles. However, when infected with the Coxsackie virus, this condition is temporary, paralysis lasts for several days, and then muscle tone is restored.

Heart diseases. A severe form of inflammation of various elements of the heart occurs (muscles, internal septum, pericardial sac). The child experiences a high temperature, a drop in blood pressure, shortness of breath, tachycardia, and arrhythmia. Pain in the heart appears, the liver enlarges. Convulsions may occur.

This condition in newborns ends in death. The risk of death also exists in older children.

Viral (serous) meningitis. In addition to all the other symptoms of infection by the Coxsackie virus, children experience paralysis of the neck muscles, convulsions, and severe headaches. If treatment is started in a timely manner, improvement occurs within 3-5 days, and then the child recovers. There are no consequences of the disease.

Encephalomyocarditis of newborns. This disease occurs in babies who become infected with the group B virus in utero or during childbirth. Infection also occurs after birth if one of the health workers caring for the newborn is a virus carrier. The child experiences convulsions, acute cardiac and respiratory failure, and brain damage. The fontanelle bulges and the nasolabial triangle turns blue. In approximately 70% of cases, the baby dies.

Video: Variants of enteroviral infections in children

What symptoms should you see a doctor for?

A sick baby should be seen urgently by a doctor in the following cases:

if the temperature does not subside within 3 days, chills, delirium, hallucinations appear, and the baby does not eat for 24 hours;
there are signs of dehydration (urinating less frequently than after 8 hours, lack of tears when crying, dry tongue and lips, drowsiness, headache, dizziness, blue under the eyes);
signs of cardiovascular pathologies appear (severe tachycardia, pale face, blue discoloration of fingers and nails);
Stiffness of the neck muscles occurs (the child arches his head back and cannot press his chin to his chest).

Diagnostics

In order to recognize the nature of the disease, it is necessary to contact a pediatrician, who, if a viral infection is suspected, will give a referral to an infectious disease specialist. The type of virus is determined using blood tests, such as PCR (determining the genetic characteristics of the microbe) and ELISA (detecting specific antibodies to the virus).

In addition, a microscopic examination of mucus from the nose, pharyngeal swabs, as well as tear fluid and feces is carried out. A scraping is taken from the affected skin rash.

Tests make it possible to distinguish complications that arise from infection with the Coxsackie virus from diseases that have similar manifestations. These include: chicken pox, mumps, rubella, measles, scarlet fever, various skin diseases (eczema, scabies, streptoderma).

Consultations with a cardiologist, otolaryngologist, neurologist and ophthalmologist may be prescribed. However, additional research may be required.

Video: Symptoms of Coxsackie virus infection. Treatment and prevention of the disease

Treatment of diseases

Hospitalization of children infected with the Coxsackie virus is carried out if severe dehydration is observed, signs of cardiac and respiratory failure appear, paralysis or convulsions occur, and a high temperature lasts more than 3 days. Treatment is aimed at suppressing the replication of the virus and strengthening the body's defenses, as well as eliminating symptoms.

Symptomatic treatment

Medications are used to reduce fever (nurofen, ibuprofen, paracetamol), as well as to reduce itching (antihistamines - Zyrtec, Suprastin, Fenistil gel).

Gargling the throat and mouth is done with chamomile infusion, which will not harm the baby, even if he swallows it. To treat herpetic sore throat in children over 3 years of age, Miramistin is used in the form of a spray to treat the oral cavity.

To relieve pain, rashes in the mouth are lubricated with gels containing novocaine, such as Kamistad or Kalgel.

Specific and restorative treatment

Antibiotics are prescribed only when it is established that a bacterial infection has been added to the viral infection.

The need to use antiviral agents is decided individually. In case of meningitis, dehydration is performed - the introduction of drugs to eliminate cerebral edema (glycerol, glucose solution, magnesium sulfate, as well as diuretics - furosemide or diacarb).

During treatment, immunomodulators (interferon, polyoxidonium), as well as various vitamins are prescribed. After recovery, the child must remain in quarantine for at least 2 weeks.

Features of caring for a sick child

If your baby has a rash in the mouth and it hurts to eat, it is necessary to lubricate the mucous membrane with anesthetic novocaine gel before eating. It is important to give the patient water frequently to prevent dehydration. This also helps reduce the temperature. It is advisable to do without a bottle with a nipple, which will further irritate the mucous membrane and increase pain. If you can’t give your baby something to drink from a cup, you can use a spoon or syringe.

It is better to give food pureed. The food should be only slightly warm. You shouldn't salt it too much. You should not give your baby sour fruits or citrus fruits.

Prevention measures

It is very difficult to avoid infection with the Coxsackie virus. Therefore, if there is a viral epidemic, you should not visit crowded places with your baby. It is necessary to protect him from contact with sick children or adults.

The child should be taught to observe the rules of hygiene and monitor the cleanliness of the premises.

Childhood infections are caused by a huge number of microorganisms. One of these is the Coxsackie virus. It belongs to the pathogens of children with a polymorphic clinical picture. It is a highly contagious RNA virus and prefers the acidic environment of the stomach. However, it settles not only in the human gastrointestinal tract; practically any tissue and organs can become its target. The nervous system is often affected when infected. But the most likely manifestation of infection is diarrhea, general intoxication, and a characteristic rash. The disease is characterized by a generally favorable course, however, in some cases dangerous complications develop.

A little history

It cannot be said that infections caused by the Coxsackie virus have been thoroughly studied. People have long been faced with diseases that have characteristic symptoms. At the end of the 19th century, an epidemic of myalgia was noted in Spain. And at the beginning of the 20th century, outbreaks of serous meningitis were observed in the USA and France. Coxsackie viruses had not yet been discovered at this time. And only successful research in the field of virology in the middle of the 20th century made it possible to isolate viral particles from the fecal masses of sick people.

It is interesting that the first sick people in “modern history” exhibited signs taken to be manifestations of polio. This happened in the American town of Coxsackie, whose name was immortalized in the history of medicine.

Routes of transmission and development of infection

A person can become infected from another sick person, and often from a virus carrier. People often catch the infection in hotels in Turkey, Cyprus or other holiday destinations. The Coxsackie virus, like the virus, is transmitted by airborne droplets. The second way of entry into the body is nutritional. Shared utensils and dirty hands can become a source of infection. Infection from unwashed fruits and vegetables is possible. But the most likely way the virus enters the body is through the upper respiratory tract.

The most susceptible category to the disease is children of preschool and primary school age. Interestingly, infants almost never become infected with the Coxsackie virus. This is probably due to the fact that mother's antibodies remain in their blood for about 6 months, protecting the newborn from a variety of infections. Gradually, the activity of these security guards decreases, and children become more susceptible to infection. Babies whose mother feeds breast milk for a long time are in an advantageous position. As you know, it is through breast milk that antibodies enter the child’s body. But still, the issue of immunity has not been fully clarified. There have been cases of very severe forms of the disease in newborns.

photo: skin symptoms of Coxsackie virus in a child

The outcome of the infection is determined by the type of virus and the personal characteristics of the patient’s body:

The person recovers completely (all viral particles are destroyed).
The process becomes chronic (neurons and internal organs retain the virus indefinitely).
The patient becomes a virus carrier.

Interestingly, parents sometimes find out that a child is infected with the Coxsackie virus when they notice his nails peeling off. This is a late sign of the disease.

Varieties of Coxsackie virus

Most known species (24) belong to type A. Their localization is mucous membranes and skin. If a child is infected with this particular serotype of the virus, then the disease may manifest itself in the form of serous meningitis, vesicular stomatitis, or acute hemorrhagic conjunctivitis. The question of the pathogenicity of type A virus species still remains open.
All type B viruses pathogenic. They affect the pleura, heart, and pancreas. The liver is especially affected.

Manifestations of the Coxsackie virus

It usually takes about ten days from the moment of infection. In some cases, the incubation period is rapid - 2 days. The disease develops rapidly, with a high temperature of 39˚ and above, nausea and even vomiting.

The head may hurt, the tongue becomes covered with a whitish coating. There is an enlargement of the lymph nodes, increased heart rate, and an enlarged liver and spleen. Itchy rashes appear on the skin - in the area of the feet, palms, fingers, near the mouth. But these are general manifestations. Depending on the predominant localization of the virus, the disease can develop in different directions.

Flu-like form

It is also called summer flu or three-day fever. This is the mildest course of the disease. Its signs are very similar to the banal one. The period of infection development is about 3–4 days. True, the body temperature can rise to 39–40˚ C, but in a short time everything goes away without consequences, and the child recovers.

Enteroviral exanthema

The main distinguishing feature of this form is a rash on the arms, chest and even head. The bubbles that appear burst and form crusts. In these places, the skin may peel and flake off. At the same time, the child’s body temperature rises. This manifestation of the disease is often confused with rubella or chickenpox. But it passes, like the flu-like form, quite quickly (from 3 to 5 days) and without consequences. This variety is often called “Boston fever”, as it was first described after an epidemic in Boston in the middle of the last century.

photo: manifestations of enteroviral exanthema when infected with the Coxsackie virus

Herpangina

The incubation period for such an infection is 1–2 weeks. In this case, the virus infects the mucous membrane of the pharynx. Signs of the disease: high fever, weakness, sore throat. Although this form was called , the symptoms of the form familiar to most are not observed. The condition is aggravated by headache. The lymph nodes may become enlarged and a runny nose may develop.

rashes with herpetic sore throat

Unlike classic sore throat, bubbles with liquid appear on the mucous membrane of the tonsils and oral cavity. After a while they burst. Upon examination, you can observe a cluster of small erosions covered with a white coating. The disease is even more similar to stomatitis than to a sore throat. All symptoms disappear in about a week.

Hemorrhagic conjunctivitis

It develops at lightning speed - no more than 2 days pass from the moment of infection to the first signs. This form of infection is characterized by a feeling of sand in the eyes, pain, photophobia, lacrimation, swelling of the eyelids, numerous hemorrhages, and purulent discharge from the eyes. Usually one eye is affected first, then symptoms appear in the other eye. At the same time, the patient feels relatively well. The illness lasts for two weeks.

Intestinal form

Symptoms are typical for: dark diarrhea (up to 8 times a day), vomiting. The condition is aggravated by abdominal pain and fever. In young children, in addition to intestinal symptoms, a runny nose and sore throat may begin. Typically, diarrhea lasts from 1 to 3 days, complete restoration of intestinal functions occurs after 10–14 days.

Children (up to 2 years old) may develop complications in the form of intolerance to dairy products. This occurs due to the virus disrupting the production of the lactase enzyme, which breaks down lactose into glucose and galactose. For such children, you need to purchase a medication with lactase at the pharmacy. Also, instead of cow's milk, you can buy special lactose-free milk at a baby food store.

Important! Preparations containing enzymes are sold in pharmacies without a prescription. However, they must be used after a doctor’s prescription.

Poliomyelitis-like form

All manifestations are similar to polio. But unlike it, paralysis develops at lightning speed; the affected muscles are not so severe and recover quickly. With this form, as with others, all the classic symptoms of infection with the Coxsackie virus may be observed: rash, fever, diarrhea.

Hepatitis

The Coxsackie virus can attack liver cells. The organ increases in size, and there is a feeling of heaviness in the right side.

Pleurodynia

The disease manifests itself in the form of muscle lesions. When the virus settles in the muscles, myositis develops. Pain is noted in different parts of the body. Very often, painful manifestations are localized in the intercostal muscles. In this case, breathing may be difficult, but the pleura is not damaged, despite the name “pleurodynia.” When walking or performing any other movements, the pain intensifies. Usually they are wavy in nature (repeated after a certain period of time). Therefore, sometimes this form of the disease is called “devil’s contraction”. The temperature may persist for several days. Fortunately, this form is quite rare.

Heart problems

Endocarditis, pericarditis, and myocarditis may develop. Chest pain and weakness are noted. The disease develops when infected with type B viruses. A very severe form. Blood pressure may drop, temperature may rise, and the child constantly wants to sleep. Manifestations of tachycardia, shortness of breath, arrhythmia, edema and liver enlargement are also common. If the central nervous system is affected, convulsive attacks are observed. A child can die literally a few hours after the first signs appear. This form of infection often develops in newborns, but can appear in older children and adults.

Serous meningitis

In another way, this species is called viral, as it occurs as a result of a viral infection. It can be caused by various viruses, including the Coxsackie virus. As the disease develops, the meninges are affected. Meningitis is characterized by:

Acute onset;
Fever;
Muscle pain and cramps;
General malaise;
Lack of appetite;
Abdominal pain and diarrhea;
, runny nose;
Drowsiness;
Fainting;
Paresis.

The clinical picture becomes less pronounced after 3–5 days.

If serous meningitis is detected in a timely manner and treated correctly, it resolves without complications.

Treatment

If the disease proceeds without complications, then it is treated in the same way as ordinary acute respiratory viral infections. In general, it is enough to undergo treatment at home. Pathogenetic and symptomatic therapy is carried out:

When treating an infection at home, you should pay close attention to the child’s condition.

An urgent call to a pediatrician is necessary if a child is found to have:

Pallor of the skin;
Appearance of blue discoloration on the body, near the ears, between the fingers;
The appearance of signs of dehydration: lethargy, dry lips, decreased urination, increased drowsiness, delirium, dizziness;
Severe headache;
Refusal to eat;
Long fever.

If the infection develops severely, urgent hospitalization is necessary.

Consequences of the disease

In general, infection with the Coxsackie virus occurs without complications. But in some cases the disease has consequences. The heaviest of them:

Meningitis;
Encephalitis;
Paralysis;
Heart failure;
Diabetes is insulin dependent.

How to prevent infection

No one knows how dangerous infection with the Coxsackie virus is. It will be good if everything turns out to be a banal three-day fever. What if the disease is complicated by myocarditis or meningitis?

To date, no vaccine has been obtained for the Coxsackie virus, as well as for other enteroviruses. The only prevention is personal hygiene. But since the main route of transmission of the virus is still airborne, this method is not a panacea. It is advisable for the child to spend less time in crowded places, especially during the epidemic period.

Be careful about summer infections - they are not as harmless as they seem at first glance.

Important! The patient should be isolated from healthy children and adults. It is advisable that the isolation lasts about 1-1.5 weeks. It is advisable to administer 7-globulin to children in areas of infection.

Video: signs of Coxsackie virus and other enteroviruses - Dr. Komarovsky

The viral infection called can affect a person of any age and gender. But this disease is especially dangerous for children under 5 years of age with an undeveloped immune system. After the infection develops, the child develops lifelong protection that prevents re-infection of the body by the pathogenic pathogen.

Children become infected with the Coxsackie virus after contact with another sick person or virus carrier. Penetration of infection into the environment occurs through airborne droplets or the fecal-oral route. The virus is quite resistant to various external influences. It is able to maintain its vital activity for about 2.5 years, which is lost only after using special disinfectants, boiling or drying.

Coxsackie in children is called the disease of dirty hands. In 97% of cases, the infection develops from eating unwashed food, contaminated water or through household items. Less commonly, the virus enters the human body through contaminated water bodies or a swimming pool. Various insects - cockroaches, flies - can become carriers of Coxsackie.

The fecal-oral route of transmission of the virus predominates in young children. The infection can pass from mother to child through the placenta during fetal development. Most cases of Coxsackie in children are recorded in the summer-autumn period.

Types and symptoms of Coxsackie virus in children

After contact with a carrier of the Coxsackie virus, the first manifestations of the disease are observed only on days 2–10. The incubation period is not accompanied by any negative signs. The onset of the disease coincides with malaise and loss of strength. Gradually, the main symptoms appear, on the basis of which one can draw a conclusion about the course of the pathological process in the body.

Symptoms of the disease depending on the stage of development

Symptoms of coxsackie in children depend on the stage of development of the disease.

Initial phase

A sick child suddenly feels unwell, which is accompanied by a rapid increase in body temperature to 39–40°C. Against the background of this condition, other symptoms of the disease appear:

submandibular lymph nodes increase in size;
the appearance of a yellow coating on the surface of the tongue;
the child feels tired, becomes lethargic, drowsy;
headaches appear.

Period of rash

1–2 days after the body temperature rises, rashes characteristic of Coxsackie appear on the child’s body. They are predominantly localized on the surface of the cheeks, palate, and near the mouth.

The rashes have watery contents and their diameter usually does not exceed 2 mm. Gradually, the pimples burst, and in their place ulcers with a reddish bottom form.

A viral infection leads to pain in the areas where the rashes are located. As a result, the child becomes whiny, irritable, eats poorly, and salivation increases.

Soon, rashes appear on other parts of the body - lower and upper extremities. They are localized on the surface of the feet, palms, and between the fingers. Single rashes appear on the surface of the buttocks, genitals, and forearm. Coxsackie in children is rarely accompanied by itching. However, you should protect your baby from scratching the skin, which can lead to secondary infection.

When a rash is detected due to the activity of the virus, signs of digestive disturbances develop in parallel. The patient complains of bloating, nausea, diarrhea, and vomiting. Bloody inclusions, mucus, and sometimes pus can be found in the stool.

Recovery period

A peculiarity of the child’s body is that the Coxsackie virus cannot manifest itself in a negative way for a long time. A significant improvement in the patient’s well-being occurs already 5–10 days after the increase in body temperature. The duration of treatment increases if infection penetrates into the resulting erosions and suppuration occurs. Re-infection with a different type of Coxsackie virus infection is possible. In this case, the disease is easier and recovery occurs faster.

Atypical forms of Coxsackie

The Coxsackie virus provokes quite complex forms of diseases in children that occur in a special way:

serous meningitis. The main symptom is a stiff neck, which is manifested by the fact that the child cannot raise his head;
herpangina. Many ulcers appear on the tonsils, which is accompanied by severe pain;
enteroviral exanthema. The main manifestation of the virus is a skin rash;
enteroviral conjunctivitis. The mucous membrane of the eyes is affected, the patient suffers from photophobia;
hepatitis. A viral infection leads to liver damage, which causes heaviness in the abdomen, heartburn, and the organ increases in size;
enteroviral gastroenteritis. Digestive disorders (intestinal localization of infection) come to the fore;
heart damage. The virus provokes the appearance of vesicle-like elements in the organ, which leads to inflammation;
encephalomyocarditis. Most often it manifests itself in premature babies and is accompanied by damage to the heart and brain;
enteroviral fever. Characterized by the absence of other symptoms other than increased body temperature;
epidemic myalgia. Manifested by pain in all muscle groups;
polio-like variant. Accompanied by paresis or paralysis of the lower extremities.

Diagnosis of the disease

After children are infected with the Coxsackie virus, a set of measures is carried out to make an accurate diagnosis, including:

visual examination of the child. Rashes characteristic of this viral infection are detected;
general and biochemical analysis of blood and urine;
serological study.

In case of a complicated or atypical course of the disease, consultation with a cardiologist, ophthalmologist, rheumatologist, pulmonologist, gastroenterologist and other highly specialized specialists is necessary.

Treatment

Typically, treatment of a child with Coxsackie is carried out at home. Hospitalization is necessary only for complicated cases of the disease. For the entire period of therapy until complete recovery, the child should be isolated from the children's team (usually for 2 weeks).

List of drugs used

In the presence of this viral infection, symptomatic therapy in the following areas is predominantly used:

taking enterosorbents (Enterosgel,). Helps prevent dehydration of the body due to vomiting and diarrhea;
eliminating pain and reducing body temperature. Ibuprofen or Paracetamol is mainly used;
local antiseptic treatment of mucous membranes affected by the virus. Furacilin, Faringosept, Kalgel are used;
leather processing. Fukortsin, chamomile decoction is used;
antihistamines. Suprastin, Zyrtec are used;
antibiotics. Prescribed exclusively in case of secondary infection;

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If coxsackie develops in children, appropriate care should be provided, including the following:

Until full recovery, the child must have his own dishes and personal hygiene items;
It is best when the patient has minimal contact with healthy family members;
due to dehydration, the child must be forced to drink a lot;
the patient must remain in bed;
until complete recovery, the baby should eat light foods rich in vitamins and minerals;
Citrus fruits, salt and hot dishes that can lead to irritation of the mucous membrane should be excluded from the patient’s diet.

Possible complications and prognosis

Coxsackievirus in children rarely causes serious complications and has a favorable course. Only in rare cases is it possible to develop severe complications:

dehydration of the body. The smaller the child, the more difficult it is for him to tolerate the loss of fluid along with vital substances;
development of serous meningitis;
the development of herpetic sore throat, which is severe and is accompanied by the formation of deep ulcers on the mucous membrane;
inflammation of the heart muscle - myocarditis;
encephalitis;
development of heart failure;
cerebral edema.

In some cases, this viral infection can cause serious incurable pathologies in a sick child or cause death.

Virus prevention

Prevention of Coxsackie involves excluding any contact with other children and, if possible, adults with an infected child. If the human body has not previously encountered this virus, there is an extremely high risk of developing this disease. Prevention of Coxsackie also involves following these recommendations:

if possible, it is necessary to avoid places with large crowds of people in the autumn-summer period, when the virus is more active;
all food must be properly washed and cooked;
after visiting the street or toilet, before eating, you must wash your hands thoroughly with soap;
It is useful to regularly ventilate the room where the child is constantly located;
It is allowed to consume only properly purified water from proven sources for food;

Walking in the fresh air helps strengthen the immune system and does not pose a risk of infection.

Enterovirus infection is a serious threat to the life and health of a child, so every adult should know how to treat the coxsackie virus. The disease is characterized by a polymorphic clinical picture and is a highly contagious disease. Microorganisms that cause the development of the disease prefer the acidic environment of the stomach. However, the infection can be located not only in the gastrointestinal tract (gastrointestinal tract), but also in any organs and tissues in the human body. Cases have been recorded in which the coxsackie virus even affected nerve cells.

What is coxsackievirus

Coxsackie virus belongs to the enterovirus family, which means the infection belongs to the intestinal tract. The first mention of this disease was discovered in 1950 in the town of Coxsackie (USA). The disease has two types: some patients suffer from type a virus, others from type b. The groups differ from each other in antigenic properties; both representatives of the infection are sensitive to the effects of disinfectant solutions and sunlight. They die in boiling water within 20 minutes.

In all other cases, the above-mentioned virus serotypes exhibit resistance to environmental conditions. Children aged 3 to 10 years are most at risk of infection. One of the main features of the disease is the lack of formation of stable immunity after suffering from the disease. The coxsackie virus is sometimes called the “summer flu” due to the occurrence of the epidemic period mainly in the warm season. The disease causes the development of hand-foot-mouth syndrome, which includes manifestations of enanthema and exanthema.

Incubation period

The first signs of intestinal flu are similar to the symptoms of a cold: deterioration in health, severe fever, inflammation of the muscles of the thoracic region. The incubation period of the disease lasts from 2 to 10 days, after which the negative manifestations become more noticeable. Blisters with liquid appear on the feet, palms, forearms, genitals, or even in the mouth of patients, which is similar to an allergic reaction.

These neoplasms do not cause severe itching, but cause pain upon contact. The virus affects the intestines and stomach, leading to vomiting or diarrhea. In the absence of proper treatment, the infection can cause the following complications: viral meningitis, diabetes mellitus, myocarditis, paralysis, inflammation of the central nervous system.

General symptoms of the disease

Specific symptoms that indicate the development of this disease begin to develop about a day after infection. Characteristic signs of the presence of enterovirus infection in the human body are the appearance of painful small blisters or ulcers on the oral mucosa. Such tumors can cover the tonsils, causing throat diseases.

The appearance of vesicles on the palms and soles indicates the progression of the coxsackie virus; in appearance, the rash resembles chickenpox. Patients also experience a high fever that persists for several days. In the classic course of infection, the condition returns to normal after a couple of days. Against the background of the above-mentioned manifestations, dyspeptic syndrome develops, which involves diarrhea and vomiting.

Treatment of coxsackie virus

The disease is subject to symptomatic or supportive therapy, since a vaccine against the coxsackie virus has not yet been invented. At the moment, there are no specific medications against this infection, however, with complex treatment of the disease, the doctor will be able to select effective drugs. It is important to remember to observe the rules of personal hygiene, since one of the routes of transmission of the virus is fecal-oral (dirty hand disease).

If you have symptoms of dehydration, you should definitely drink enough water per day to prevent further development of intoxication. Local anesthetics are prescribed to treat sore throats or mouth ulcers. Fukortsin and brilliant green are used to treat rashes on the patient’s skin. For headaches and fever, experts recommend taking all kinds of anti-inflammatory drugs, for example, Ibuprofen. In case of severe infection, it is necessary to use antiviral drugs like Amiksin.

In adults

Any adult with a weakened immune system can catch a childhood infection. In order to get sick, all it takes is contact with a carrier of the coxsackie virus. Airborne infection is one of the most common methods of transmission of enteroviral fever, which has been confirmed by numerous clinical cases. Sometimes it can be problematic to correctly diagnose a patient, because some types of the virus are characterized by asymptomatic development.

Treatment of coxsackievirus in adults depends on the severity of symptoms. When diagnosing the disease, strong antiviral drugs should be taken within the first three days. Further progression of the infection indicates the need for symptomatic therapy, which includes: diet, bed rest, and drinking plenty of fluids.

In children

If a child shows signs of infection, you should stop visiting public places and call your local pediatrician. Treatment of the coxsackie virus in children follows the same scheme as in adults: antipyretics or antihistamines, solutions, and throat sprays are prescribed. An integrated approach to therapy will provide all the necessary conditions for the patient’s body to recover independently, which occurs approximately 10-12 days after infection.

Parents should give their baby plenty of warm drinks to reduce the temperature and remove toxins as quickly as possible. The disease rarely causes complications, but in advanced cases the infection can cause serious damage to the child's health. This occurs when the virus spreads through the systemic bloodstream, which creates favorable conditions for the penetration of microorganisms into the internal organs. Cases of serous meningitis, paralysis, necrosis of muscle tissue, damage to the meninges and other serious consequences have been recorded.

How to treat the coxsackie virus

This involves the use of medications to reduce fever, relieve pain from rashes, or treat wounds on the skin. For successful treatment, the patient should adhere to a proper diet, drink plenty of water and rest. Strengthen the immune system with the help of medications such as vitamins, interferons, sorbents, antibiotics, and antiseptics.

Local remedies to reduce itching

During the course of the disease, the patient experiences a large number of negative symptoms, one of which is severe itching. A small child is not able to endure the discomfort caused by this condition for long, so doctors often prescribe topical antihistamines for relief. These include Fenistil or Vitaon baby gel; for adults, Zyrtec or Suprastin are best suited. The above remedies help to quickly eliminate itching and normalize the patient’s well-being.

Antipyretic drugs

This category of drugs is used for the first few days in the treatment of the coxsackie virus, until the human immune system produces lymphocytes and other protective cells to eliminate the infection. During the acute stage of the disease, the patient’s temperature may rise significantly (up to 39-40 C), so the use of antipyretics is an important part of the treatment. Experts recommend the use of Paracetamol and Nurofen for both children and adults. These drugs are considered safe for human health if the indicated dosage is observed.

Taking enterosorbents

To speed up the process of removing toxins from the body, it is necessary to maintain a drinking regime and take enterosorbents. The coxsackie virus often leads to intoxication, so to alleviate negative symptoms, patients take Polysorb, Enterosgel or Lactofiltrum. The above agents absorb harmful microorganisms settled in the gastrointestinal tract, which helps eliminate the infection in a short period of time.

Antiviral drugs for the treatment of coxsackievirus

In severe cases of the disease, when it is difficult for the body to cope with the infection on its own, doctors recommend the use of antiviral drugs. The most effective remedy for children with weakened immune systems is Gamma globulin, which is developed on the basis of donor blood. It is often used as a preventive measure during an outbreak of the coxsackie virus or if a child has been in contact with an infected person. Amiksin is indicated in rare cases in the treatment of adult patients.

Antiseptics for treating the oral cavity

The Coxsackie virus affects not only the skin, but also the mucous membranes of the human body. Severe sore throat, ulcers or rash in the mouth cause severe discomfort in the patient, so doctors prescribe symptomatic treatment. Special antiseptics and anti-inflammatory drugs are used to rinse the mouth, which effectively relieve pain. Children are prescribed chamomile decoction or soda solution, adults use Hexoral, Miramistin, Stomatidin.

Antihistamines

Medicines from this category are used to alleviate negative symptoms of general intoxication of the body. Patients suffering from enteroviral eczema use antihistamines to relieve the discomfort of the disease. To eliminate itching, doctors prescribe the following medications: Erius, Claritin, Telfast, Psilo-balm. The listed medicinal substances are suitable for both external and internal use, based on the form of release of the drug.

Vitamins and microelements

The Coxsackie virus can cause serious damage to the body with a weak immune system. For this reason, experts recommend taking vitamins B and C not only during therapy, but also during an outbreak of infection. In order to protect yourself from enteroviral disease, it is important to ensure a supply of microelements necessary to maintain the body's defense mechanisms. Vitamins help fight the manifestations of intoxication and stimulate the elimination of toxins, which has a beneficial effect on the patient’s condition.

How to treat coxsackievirus during pregnancy

In most cases, enteroviral diseases during pregnancy do not pose a threat to the health of the mother or fetus. Manifestations of the coxsackie virus resemble a cold, so symptomatic treatment of pregnant women is an effective remedy against infection. However, it is very important to recognize the disease in time to prevent the development of complications. For these purposes, they resort to laboratory diagnostics, because it is impossible to accurately identify the disease from a photo from the Internet. After identifying the problem, the patient must go through several stages of treatment:

Admission to an inpatient unit at a local hospital to provide professional medical care.
Prescribing detoxification therapy to eliminate the symptoms of the coxsackie virus.
Maintain bed rest and drink plenty of water.
Collection of blood, urine, and stool tests to determine the type of infection.
Regular monitoring of the fetus's condition using ultrasound.

Prevention of enterovirus

There is currently no specific vaccine against the coxsackie virus, which is directly related to the variability of the infection. In order to protect yourself and your family from enteroviral disease, doctors recommend adhering to basic hygiene rules. For example, Dr. Komarovsky is convinced that it is important to lead a healthy lifestyle, eat right and alternate physical activity with rest.

Video

Viral infections are widespread among children of all ages. They can be caused by different pathogenic pathogens, affect different organs and systems, and have different clinical signs. Among the large number of similar diseases of viral origin, special attention should be paid to the Coxsackie virus, also known as the “Turkish virus” or “Turkish chickenpox,” epidemics of which from time to time seize different regions of our country.

Coxsackie virus, symptoms in children

Symptoms of the Coxsackie virus in children manifest themselves acutely, accompanied by fever, intoxication of the body, skin rashes that are localized on the upper and lower extremities, chest, facial skin and other pronounced signs that significantly worsen the general well-being of the child. Before considering the Coxsackie virus in children - photos, symptoms, it is important to know what this disease is, what its causes are, what the danger of the virus is, and what treatment methods will help overcome the disease.

More about the Coxsackie virus

Coxsackievirus is one of the representatives of the group of enteroviruses that multiply rapidly in the human intestine and are highly contagious (infectious). In the absence of timely treatment, Coxsackie can cause serious complications. The first outbreak of this virus in history was registered in the small American town of Coxsackie, which gave its name to the disease. The second name for the disease is the “hand-foot-mouth” virus, since it is on these parts of the body that the symptoms of a viral infection manifest themselves most strongly.

About 30 forms of the Coxsackie virus are now known. All of them belong to three groups of human enterovirus: A, B and C. The virus can enter the environment in several ways - with feces, through soil, water. Small insects can also act as carriers: bedbugs, flies, fleas and cockroaches, so epidemic outbreaks often appear in disadvantaged areas and families with a low standard of living.

The Coxsackie virus is highly contagious. It enters the victim's body in different ways. The virus is transmitted by coughing, through saliva, blood, and urine. The infection may be present on the surface of poorly washed fruits and vegetables, in water from reservoirs (including sea water), sand, on door handles and other common objects. A child who falls ill in a children's group will quickly create a real epidemic around him. The main routes of transmission of the virus are airborne droplets, household contact and food.

Coxsackievirus appears less frequently in adults. Symptoms of Coxsackie in adults are not so pronounced, often reminiscent of a common cold or allergy. Pregnant women are also at risk of contracting the virus. For the expectant mother herself, the disease does not pose a danger, but, at the same time, the virus can penetrate the placenta and infect the fetus, which in this case will be born with a viral pathology.

It is not easy to protect yourself from the Coxsackie virus, especially during its epidemic, but still following basic hygiene rules, treating your hands with an antiseptic, thoroughly processing vegetables and fruits before eating them, quenching your thirst only with filtered water, swimming in running water, you can significantly reduce the risk of infection .

Main forms of the disease

As noted above, today science knows about 30 types of Coxsackie virus, which are divided into two main types. The first (type A) includes 24 varieties of the virus - they most often affect the mucous membranes and skin.

All other varieties are classified as group B. Such pathogens are capable of infecting internal organs: heart, lungs, pancreas, subsequently provoking a number of diseases.

Regardless of what type of virus has entered the child’s body, Coxsackie virus - severe symptoms require immediate medical attention.

Main clinical signs

After contact with a viral infection and until the first signs of the disease appear, 2-3 days usually pass. The Coxsackie virus spreads quickly throughout the body, so the incubation period is quite short. Clinical signs appear acutely and may be accompanied by the following symptoms:

body temperature up to 39˚ and above;
nausea, vomiting;
headache;
tongue covered with white coating;
enlarged lymph nodes.

A characteristic sign of the disease is the appearance of itchy rashes on the skin of the arms, legs, torso and face. Rashes are often present in the mouth, affecting the mucous membrane of the throat. Skin reactions with this disease can appear 2-3 days after the first signs of the disease appear and last for several days. Coxsackie virus in adults - symptoms are not as pronounced as in children, so adults often mistake them for a common cold.

Symptoms of the Coxsackie virus depending on its type and location

Depending on the direction the infection has chosen for its development, and where the pathogen is localized, the Coxsackie virus in children manifests itself in a variety of signs and the course of the disease differs significantly.

Influenza-like form of Coxsackie virus

A common form of the virus, also known as “summer flu”. The disease has a mild course, and the symptoms themselves are similar to a common cold or acute respiratory viral infection. A characteristic sign of the disease is an increase in body temperature to 40˚ C, which lasts no more than 3 days. The symptoms are pronounced, but pass quickly. This form of Coxsackie, as a rule, does not cause complications or serious consequences.

Enteroviral exanthema

The main feature of the Coxsackie virus is that its symptoms are manifested by a rash on the arms, head, and torso. The rashes resemble small blisters that quickly burst, and crusts form in their place. There is itching and peeling in the area of the rash. In addition, the child has an elevated body temperature, which lasts for 3 days. Doctors, as well as parents, often confuse the disease with rubella or chickenpox. The prognosis for this form is favorable, improvements appear already on the 4th day of illness.

Herpangina

When this form of the disease develops, the virus lives mainly on the mucous membrane of the throat. The incubation period can take up to 2 weeks after exposure to the pathogen. There is fever, sore throat, enlarged lymph nodes, and stuffy nose.

With herpetic sore throat, small bubbles with liquid appear on the mucous membrane of the throat, bursting after a few days. In their place, erosions with a white coating appear. With proper treatment, symptoms disappear within 7 to 10 days.

Hemorrhagic conjunctivitis

It has a lightning-fast course, the first symptoms can appear already on the 2nd day after contact with the pathogen. Accompanied by a feeling of sand in the eyes, fear of light, swelling of the eyelids, profuse purulent discharge from the eyes.

Damage to the mucous membrane of the eyes by the Coxsackie virus; symptoms in adults and children are initially present in one eye, but then the other eye is infected. Apart from the pronounced clinical symptoms, the patient’s state of health is satisfactory. The disease goes away within 2 weeks, rarely leaving any consequences.

Intestinal form of Coxsackie virus

With this form of the disease, the symptoms resemble a common intestinal infection, characterized by diarrhea, acute abdominal pain, and fever.

The intestinal form of the Coxsackie virus - symptoms in adults are not as pronounced as in children, who, in addition to the main symptoms, often have a runny nose, sore throat and other catarrhal symptoms. Recovery will take up to 2 weeks.

Poliomyelitis-like form of Coxsackie virus

With this form of viral infection, all the symptoms of polio are present. Paralysis develops very quickly, but the damaged muscles, fortunately, recover quite quickly. In addition to the main symptom, there are other symptoms: rash, fever, frequent loose stools. This form of the disease is common exclusively among children. The treatment and recovery period may take up to 3 weeks.

Serous meningitis

Serous meningitis, which can be caused by different strains of the virus, the Coxsackie virus, is considered a dangerous disease of viral etiology. As the disease develops, damage to the meninges occurs, high body temperature appears - over 39 - 40 degrees, convulsions, muscle pain, fainting.

This form of the disease requires immediate hospitalization of the child. The clinical manifestations become less pronounced only after 5–7 days.

In addition to the main forms of viral infection, the Coxsackie virus can affect the cardiovascular system, liver, pancreas and other organs. Considering the complexity of each disease, as well as their similarity with other pathologies, it is almost impossible to diagnose the disease at the initial examination.

The danger of the Coxsackie virus for a child

Despite the severe symptoms that may appear against the background of diseases caused by this virus, the prognosis for recovery is quite good, and complications occur only in isolated cases. Among the complications are:

dehydration of the body;
pulmonary edema;
heart failure;
Iron-deficiency anemia.

A fatal outcome from viral infection syndrome can occur only in newborns or children with a history of diabetes mellitus or other serious illnesses.

Examination methods

You can recognize the symptoms of Coxsackie virus in children after examining the patient, collecting anamnesis, and examination results. The main factors in making a diagnosis are the results of the following examinations:

diagnostics using the PCR method - determines the causative agent of the virus in the blood;
enzyme-linked immunosorbent assay (ELISA) – detects antibodies to the virus;
blood and urine tests.

If necessary, the doctor may prescribe other research methods that will help obtain a complete picture of the disease. A sick child must be referred to other specialists: a cardiologist, an ophthalmologist, a neurologist, a gastroenterologist. Before the doctor makes a final diagnosis and prescribes treatment, the child must exclude diseases such as rubella, polio, mumps, scarlet fever, scabies or eczema.

Treatment of Coxsackie virus

Treatment directly depends on the form and severity of the disease. If there is a risk of complications or the disease is diagnosed in a child under 3 years of age, the child is hospitalized in the infectious diseases department. For mild cases of the disease, treatment is carried out on an outpatient basis. Therapy includes taking symptomatic and systemic medications that can suppress the aggressiveness of the virus and improve the child’s overall well-being. There is no specific treatment, so the doctor often prescribes symptomatic medications.

Antipyretic drugs - Panadol, Ibuprofen, Nise, Panadol.
Antihistamines are Suprastin, Claritin, Fenistil.
Antiseptics for the throat - Orasept, Chlorophyllipt, Miramistin, Kamistad.
Antiviral - Kagocel, Remantadine, Anaferon, Amiksin, Tamiflu.
Sorbents – Enterosgel, Activated carbon, Polysorb.

The doctor may prescribe other medications, since everything depends on the symptoms, the age of the child, and the characteristics of his body. Any drug, dose, therapeutic course can only be prescribed by a doctor individually for each child.

In a number of exceptions, and only if complications or a bacterial infection are suspected, the doctor may prescribe broad-spectrum antibacterial drugs.

If the disease is mild, antibiotics are not prescribed, since they are completely powerless against viruses, and taking them will only worsen the child’s general condition.

Prevention of Coxsackie infection

Despite the capabilities of modern medicine, there is no vaccine against the Coxsackie virus, so the only way to reduce the risk of getting sick is to follow the rules of personal hygiene. As practice shows, the use of antiviral drugs to prevent Coxsackie also does not bring any results. Thus, today there is no guaranteed protection against Coxsackie. The main task of responsible parents: when the first signs of illness appear or the child complains about deterioration in health, contact a doctor. The sooner the doctor examines the child and receives the examination results, the sooner he can make the correct diagnosis, prescribe treatment, and give useful advice.