Eng / Enterovirus
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Clinical forms Typical
Gerpangina
epidemic myalgia Aseptic serous meningitis Exanthems
Clinical forms Atypical
Inapparant form
Minor illness (summer flu)
Catarrhal (respiratory form)
encephalitic form
Encephalomyocarditis of the newborn
Poliomyelitis-like (spinal form)
Epidemic hemorrhagic conjunctivitis
Uveitis
Nephritis
pancreatitis
Clinic
The incubation period for EVI lasts from 2 to 35 days (usually 2-3 days).
A unique feature of enteroviruses is the ability to cause "little predictable variants" of the disease.
The same type of virus can cause both very mild, erased forms of the disease with damage, for example, to the respiratory tract or intestines, and extremely severe variants with damage to the nervous and cardiovascular systems.
Clinic
One type of virus can cause both large epidemics and single diseases. At the same time, enteroviruses of different serotypes can cause the same clinical syndromes.
Some syndromes are more common in certain age groups:
so aseptic meningitis is usually observed in infants,
and myalgia and myopericarditis in adolescents and young adults;
herpetic sore throat - in children aged 3 months to 16 years,
acute hemorrhagic conjunctivitis - in patients aged 20 to 50 years.
Clinic
The vast majority of cases of EVI (more than 80%) are asymptomatic
about 13% of cases are mild febrile illnesses
and only 2-3% of cases develop a severe form of the disease, mainly in young children and people with impaired immune systems.
Epidemic myalgia (pleurodynia, Bornholm's disease, "devil's disease").
Myalgia is more often caused by Coxsackie B viruses (1-6 serotypes), less often - Coxsackie A viruses.
This form in most cases is observed in adolescents and young adults and, in essence, is a viral myositis.
Palpation of the affected muscle is always painful, the muscle is swollen. The pain is usually localized around the edge of the costal arch.
Approximately half of patients experience pain in the lower pectoral muscles on one or both sides, while the other half experience pain in the upper abdominal muscles.
Epidemic myalgia (pleurodynia, Bornholm's disease, "devil's disease").
In children, pain can be localized even lower, mimicking the "acute abdomen" clinic. Characterized by the sudden onset of severe spastic pain in the muscles, aggravated by a change in body position, inhalation.
An attack of spasm ends the same way it begins - suddenly.
Often there is damage to the muscles of the limbs. The attack lasts from 30-40 seconds to 1530 minutes, rarely - 1 hour.
After an attack of pain, a rise in body temperature to high numbers, the appearance of myoglobinuria is possible.
The duration of the disease is short, from 1 to 6 days, the course is undulating, after 1-3 days there may be a repeated rise in body temperature.
Serous meningitis.
the most common form of damage to the central nervous system (CNS) in EVI.
acute start,
body temperature rises to 38-39°C and is constant.
Severe headache, vomiting,
sometimes impaired consciousness and convulsions.
Positive meningeal symptoms are noted.
Fever and meningeal symptoms usually persist for 3-7 days, and a two-wave temperature curve is possible.
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Serous meningitis.
Liquor flows out under pressure, transparent or slightly opalescent.
Characterized by cytosis up to 100-500 cells in 1 µl. In the early days of the disease, cytosis can be neutrophilic, later lymphocytic.
The amount of protein is normal or increased.
The content of sugar and chlorides is within the normal range.
Normalization of the CSF composition usually occurs by the end of the 3rd week.
Serous meningitis.
In infants
a pronounced intoxication syndrome, cerebral symptoms, pathological changes in the cerebrospinal fluid can be observed in the absence of positive meningeal signs (“asymptomatic cerebrospinal fluid meningitis”). This form is extremely difficult for clinical diagnosis.
In practice, aseptic meningitis is often diagnosed by lumbar puncture in febrile children with no apparent infection. (a positive PCR result in CSF reliably confirms the etiology of the disease.