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Viral Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Overview: Hand-foot-mouth disease (HFMD) is a viral exanthem characterized by eruptions on the palms and soles with mouth ulcers. It is caused by multiple serotypes of the coxsackievirus, which is an RNA enterovirus, and most commonly Coxsackievirus A16. Enteroviruses are spread person-to-person, the fecal-oral route, respiratory route, or through direct inoculation. Outbreaks frequently occur during the summer and the fall.
Other viral infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Diseases attributed to enteroviruses include aseptic meningitis, encephalitis, myocarditis, hepatitis, pneumonia, pleurodynia, and orchitis. Though often asymptomatic, infection may manifest with rashes, pharyngitis and conjunctivitis, parotitis, pericarditis, and pancreatitis. Rarely, the infection may be fulminant and fatal.
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
Diagnosis – CSF pleocytosis (100–1000 cells/μL) with lymphocyte predominance is seen, although there may be a neutrophil response during the first 6–48 hours in as many as two-thirds of patients. Mild elevations of CSF protein with slightly low or normal glucose are common. Enterovirus culture is positive in 4–8 days in the laboratory in 65–75% of cases.3,6 Culture of enterovirus from the oropharynx or GI tract is suggestive, but viral shedding occurs in 7–8% of healthy controls during epidemics of enterovirus. Enterovirus PCR from the CSF is more sensitive (86–100%) and specific (92–100%) than culture, with a faster time to results, and is the diagnostic test of choice.7–9
An Atypical Case of Enterovirus Meningitis Presenting with Unilateral Optic Disc Swelling and Minimal Optical Symptoms
Published in Ocular Immunology and Inflammation, 2023
Efthymios Karmiris, Georgios Vasilakos, Konstantinos Tsiripidis, Evangelia Chalkiadaki
Aseptic meningitis is defined as an acute infectious disease with CSF negative for bacteria and is most frequently due to a viral infection. Viruses are often overlooked as their sequelae are not as severe as bacterial meningitis or viral encephalitis, with the most common clinical symptoms for aseptic meningitis patients being fever, vomiting, headache and nausea. Viruses may reach the meninges from the bloodstream or be reactivated from a dormant state within the nervous system.7 Herpes-, arbo- and enteroviruses are the major etiologic agents of central nervous system infections, however their causative role among adult cases of aseptic meningitis is unclear.8 They preferentially cause harm in the very young9 and children are the primary victims of central nervous system infections due to enteroviruses. Therefore, little is known about the natural history of enterovirus meningitis in adults.6
Infant botulism: an underestimated threat
Published in Infectious Diseases, 2021
Luca Antonucci, Cristian Locci, Livia Schettini, Maria Grazia Clemente, Roberto Antonucci
In the absence of serious hospital-acquired complications, the prognosis for IB patients is excellent, with anticipated full and complete recovery. In the United States, the mortality rate for IB is less than 1% [40,104]. The course of recovery from IB usually proceeds with a gradual improvement in muscle function, usually without relapses. The worsening of clinical symptoms during the recovery of the patient should let the physician suspect a complication or inadequate respiratory or nutritional support. Infection is the most common complication and can affect the middle ear (otitis media), lungs (aspiration pneumonia) and urinary and intestinal tracts. Regarding intestinal involvement, patients should be carefully monitored for signs of secondary C. difficile infection (diarrhea, change in stool colour, abdominal tenseness, or distention), which can result from colonic stasis due to botulism. Bacteraemia and sepsis may also develop from indwelling venous lines [40,104,106]. Among complications, concomitant intestinal viral infections (mostly caused by enteroviruses) have been also described [125]. Infections and other potential causes of clinical deterioration are listed in Table 5 [72]. Sedatives or other drugs potentially resulting in CNS depression are relatively contraindicated [40].
Hypothetical emergence of poliovirus in 2020: part 1. Consequences of policy decisions to respond using nonpharmaceutical interventions
Published in Expert Review of Vaccines, 2021
Kimberly M. Thompson, Dominika A. Kalkowska, Kamran Badizadegan
We use our exiting global poliovirus transmission model [48], but initialize the population in 2020 assuming no prior immunity or exposure to polioviruses (i.e. a completely naïve population with no immunologically cross-reactive species). This represents a completely different situation than what actually exists, because historical endemic transmission and widespread use of polio vaccines currently imply very high levels of individual and population immunity. We ignore any cross-protection that may exist from prior exposure of some individuals in the population to any related enteroviruses. Since three independent stable serotypes of wild polioviruses (WPVs) exist (WPV1, WPV2, and WPV3) with different properties [48], we model each independently to show the different behaviors with respect to transmission dynamics and expected disease burden. We refer to these generally as novel WPV (nWPV) and specifically as nWPV1, nWPV2, and nWPV3 to indicate properties like the existing WPV serotypes.