What are the signs and symptoms of exanthems caused by coxsackievirus infection?

Updated: Aug 24, 2018
  • Author: Martha L Muller, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Two of the more distinctive exanthems caused by coxsackievirus hand-food-and-mouth disease (HFMD) and herpangina.

HFMD often affects children and spreads easily to other family members. Patients present with a sore throat and mouth. Vesicles that coalesce, form bullae, and then ulcerate form on the buccal mucosa and tongue. Seventy-five percent of patients have peripheral cutaneous lesions at approximately the same time. Biopsy reveals intracytoplasmic viral particles. The most common virus isolated is coxsackievirus A16. Numerous cases of a more severe HFMD caused by coxsackievirus A6 were reported between 2004 and 2011 in several Asian and European countries. [5] Additionally, between 2011 and 2012 in the United States, several cases of severe HFMD were reported, with 74% of those cases testing PCR positive for coxsackievirus A6; about 25% of reported cases were in adults. [5]

Herpangina is a vesicular enanthem of the posterior oropharynx with fever, sore throat, occasional throat exudate, odynophagia, and dysphagia, which is observed more often in young children than in adolescents and adults. Prompt recovery is typical, with almost all patients recovering completely. Group A coxsackieviruses are the most common viruses isolated from herpangina patients.

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