Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 32-10: Enteroviruses that Produce Several Syndromes + Key Features Download Section PDF Listen +++ ++ Named after a town in northern New York State, the coxsackievirus causes several clinical syndromes More than 50 serotypes and 2 major subgroups: A and B Enterovirus occurs most often during the summer months + Clinical Findings Download Section PDF Listen +++ ++ Herpangina (subtype A; B3) Sudden-onset fevers Headaches Myalgias Petechiae or papules on the soft palate that ulcerate in about 3 days and then heal Epidemic pleurodynia (Bornholm disease, subtype B) Pleuritic chest pain Systemic symptoms, including headache, malaise, pharyngitis Aseptic meningitis (subtypes A and B) Fever Headache Stiff neck CSF lymphocytosis Encephalitis and transverse myelitis may occur Acute pericarditis (subtype B) Positional, pleuritic chest pain Fevers Myalgias Clinical and echocardiographic signs of pericarditis Hand-foot-and-mouth disease (subtypes A and B) Stomatitis Vesicular rash on hands and feet Nail dystrophies and onychomadesis (nail shedding) Hepatitis, renal disease, and myocarditis are also caused by coxsackievirus infections + Diagnosis Download Section PDF Listen +++ ++ Clinical diagnosis No reliable laboratory abnormality Neutralizing antibodies appear during convalescence + Treatment Download Section PDF Listen +++ ++ Supportive measures For patients with enteroviral meningitis, pleconaril has shown potential clinical benefit although the compassionate use of this drug has stopped In severe cases, immunoglobulin treatment is anecdotally successful