RESUMO
INTRODUCTION: In rare occasions, coxsackievirus infections can cause serious illness, such as encephalitis and myocarditis. The immunotherapies of cancer could increase the risk of myocarditis, especially when applying immune checkpoint inhibitors. Herein, we report a rare case of Coxsackie B virus-induced myocarditis in a patient with a history of lymphoma. CASE PRESENTATION: A 32-year-old woman was admitted to the hospital with recurrent fever for more than 20 days, and she had a history of lymphoma. Before admission, the positron emission tomography/computed tomography result indicated that the patient had no tumor progression, and she was not considered the cancer-related fever upon arriving at our hospital. Patient's red blood cell, platelet count, and blood pressure were decreased. In addition, she had sinus bradycardia and 3 branch blocks, which was consistent with acute high lateral and anterior wall myocardial infarction. During hospitalization, the patient had recurrent arrhythmia, repeated sweating, poor mentation, dyspnea, and Coxsackie B virus were detected in patient's blood samples by pathogen-targeted next-generation sequencing. The creatine kinase, creatine kinase MB, and N-terminal pro-brain natriuretic peptide were persistently elevated. Consequently, the patient was diagnosed with viral myocarditis induced by Coxsackie B virus, and treated with acyclovir, gamma globulin combined with methylprednisolone shock therapy, trimetazidine, levosimendan, sildenan, continuous pump pressors with m-hydroxylamine, entecavir, adefovir, glutathione, pantoprazole, and low-molecular-weight heparin. Her symptoms worsened and died. CONCLUSION: We reported a case with a history of lymphoma presented with fever, myocardial injury, who was ultimately diagnosed with Coxsackie B virus-induced myocarditis. Moreover, pathogen-targeted next-generation sequencing indeed exhibited higher sensitivity compared to mNGS in detecting Coxsackie B virus.
Assuntos
Infecções por Coxsackievirus , Linfoma , Miocardite , Viroses , Humanos , Feminino , Adulto , Miocardite/diagnóstico , Miocardite/etiologia , Enterovirus Humano B , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , FebreRESUMO
PURPOSE: An acute conjunctivitis outbreak was investigated at a residential school in Naharlagun, Arunachal Pradesh, Northeast India, in July 2023. We aimed to identify the etiological agent and assess any complications in follow-up cases. METHODS: We used a structured questionnaire to record clinical findings and followed up with cases one-month post-conjunctivitis. Sixty-one cases were examined and eight conjunctival and oropharyngeal swab samples were collected after obtaining informed consent from guardians/school authorities. We screened for 33 viral and bacterial pathogens using an IVD-approved Real-time PCR assay. Further, the samples were subjected to nucleic acid sequencing. RESULTS: Among 465 screened students and staff, 80 individuals (approximately 17.2%) showed acute hemorrhagic conjunctivitis symptoms among which 61 cases were available for clinical examination. We identified the Enterovirus responsible by targeted sequencing using next-generation sequencing. The etiological agent was found to be Coxsackievirus A24, a member of Enterovirus C, in seven out of eight samples subjected to sequencing. Common symptoms included conjunctival hyperemia and foreign body sensation (100%), bilateral eye involvement (73.8%), eye pain (70%), watery discharge (49.2%), and eyelid swelling (38%). Only 6.5% had purulent discharge. Most cases resolved within 5-6 days, with only 9.8% reporting abdominal symptoms post-conjunctivitis. No serious complications occurred within one month. Throat swabs aided in diagnosing enterovirus infections alongside eye swabs. CONCLUSIONS: The outbreak of acute conjunctivitis was caused by Coxsackievirus A24, a member of Enterovirus C. Cases resolved spontaneously within 6-7 days, with no severe complications. Collecting oropharyngeal swabs alongside conjunctival swabs could improve enteroviral conjunctivitis diagnosis.
Assuntos
Conjuntivite Hemorrágica Aguda , Surtos de Doenças , Enterovirus Humano C , Humanos , Índia/epidemiologia , Conjuntivite Hemorrágica Aguda/epidemiologia , Conjuntivite Hemorrágica Aguda/virologia , Masculino , Feminino , Enterovirus Humano C/isolamento & purificação , Enterovirus Humano C/genética , Criança , Adolescente , Instituições Acadêmicas , Adulto , Adulto Jovem , Infecções por Coxsackievirus/epidemiologia , Infecções por Coxsackievirus/virologia , Infecções por Coxsackievirus/diagnósticoRESUMO
We report an acute Coxsackievirus B3 (CVB3)-induced meningo-cerebellitis in an immunocompetent adult patient. CVB3 has a global distribution and is the most common Enteroviruses cause of myocarditis and sudden cardiac death. To our knowledge, CVB3 is exceedingly rare as causes of meningo-encephalitis in immunocompetent adults, whereas some cases have been reported in neonates due to perinatal acquired infections or in immunocompromised patients.
Assuntos
Infecções por Coxsackievirus , Infecções por Enterovirus , Enterovirus , Miocardite , Recém-Nascido , Humanos , Adulto , Infecções por Coxsackievirus/diagnóstico , Enterovirus Humano B/genética , Miocardite/tratamento farmacológicoAssuntos
Infecções por Coxsackievirus , Miocardite , Humanos , Miocardite/diagnóstico , Miocardite/etiologia , Miocardite/tratamento farmacológico , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Infecções por Coxsackievirus/tratamento farmacológico , Antivirais/uso terapêuticoAssuntos
Infecções por Coxsackievirus , Enterovirus , Síndrome de Linfonodos Mucocutâneos , Anticorpos Antivirais , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Humanos , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/diagnósticoRESUMO
A Gripe do Tomate é uma doença cuja etiologia ainda não está bem definida, podendo ser causada por uma variante do vírus Coxsackie, responsável pela doença mão-pé-boca ou ainda, por um quadro pós-viral de Chikungunya ou Dengue (FERREIRA, 2022; GZH SAÚDE, 2022). Embora seja conhecida por Gripe ou Febre do Tomate, a doença não possui nenhuma relação com o consumo do fruto, mas refere-se a ele pela semelhança das erupções de bolhas vermelhas e dolorosas que acometem todo o corpo e aumentam gradualmente (CAMAÇARI NOTÍCIAS, 2022; FOLHA VITÓRIA, 2022)
Tomato Flu is a disease whose etiology is not yet well defined, and may be caused by a variant of the Coxsackie virus, responsible for hand-foot-and-mouth disease, or by a post-viral condition of Chikungunya or Dengue (FERREIRA, 2022). ; GZH HEALTH, 2022). Although it is known as Influenza or Tomato Fever, the disease does not have any relationship with the consumption of the fruit, but refers to it by the similarity of the eruptions of red and painful blisters that affect the whole body and gradually increase (CAMAÇARI NOTÍCIAS, 2022; FOLHA VITÓRIA, 2022)
Assuntos
Humanos , Infecções por Coxsackievirus/prevenção & controle , Infecções por Coxsackievirus/diagnóstico , Infecções por Coxsackievirus/transmissãoRESUMO
BACKGROUND: Certain types of enteroviruses, including coxsackieviruses, cause encephalitis, and other neurological complications. However, these pathogens rarely cause fatal infections, especially in immunocompetent infants. In this study, we present a rare case of acute encephalopathy caused by coxsackievirus A2 (CV-A2), which progressed rapidly in a previously healthy female child. CASE PRESENTATION: In June 2013, a 26-month-old female child from Kanagawa, Japan, was found unresponsive during sleep. She was healthy until that morning. Her temperature was 37 °C at 08:00. She was feeling fine and went to the nursery that same morning. However, her condition worsened around noon. Therefore, she went home and slept at around 13:00. Surprisingly, after 2 h, her parents checked on her and found that she was lying on her back and was not breathing. Hence, she was immediately taken to a hospital by ambulance, but she was declared dead on arrival at the hospital. Subsequently, pathological autopsy and pathogenetic analysis, including multiple pathogen detection real-time PCR, were conducted to investigate the cause of death. The examination results revealed that she had an infectious respiratory disease and acute encephalopathy due to a CV-A2 infection. CONCLUSIONS: Based on our findings, we concluded that a previously healthy girl who had no immediate history of underlying medical condition were susceptible to death by acute encephalopathy due to CV-A2 infections. We proposed this conclusion because the patient's condition progressed rapidly in less than 2 h and eventually led to her death. This is the first report on an acute encephalitis-dependent death in a child due to CV-A2 infection.
Assuntos
Encefalopatias , Infecções por Coxsackievirus , Encefalite , Autopsia , Criança , Pré-Escolar , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Família , Feminino , HumanosRESUMO
BACKGROUND: Coxsackievirus A21 (CVA21), a member of Enterovirus C from the Picornaviridae family, has been associated with respiratory illnesses in humans. METHODS: A molecular epidemiological investigation of CVA21 was conducted among patients presenting with acute upper respiratory illnesses in the ambulatory settings between 2012 and 2014 in Kuala Lumpur, Malaysia. RESULTS: Epidemiological surveillance of acute respiratory infections (n = 3935) showed low-level detection of CVA21 (0.08%, 1.4 cases/year) in Kuala Lumpur, with no clear seasonal distribution. Phylogenetic analysis of the new complete genomes showed close relationship with CVA21 strains from China and the United States. Spatio-temporal mapping of the VP1 gene determined 2 major clusters circulating worldwide, with inter-country lineage migration and strain replacement occurring over time. CONCLUSIONS: The study highlights the emerging role of CVA21 in causing sporadic acute respiratory outbreaks.
Assuntos
Infecções por Coxsackievirus/diagnóstico , Enterovirus/genética , Variação Genética , Infecções Respiratórias/diagnóstico , Adolescente , Adulto , Proteínas do Capsídeo/classificação , Proteínas do Capsídeo/genética , Infecções por Coxsackievirus/epidemiologia , Infecções por Coxsackievirus/virologia , Surtos de Doenças , Enterovirus/classificação , Enterovirus/isolamento & purificação , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Filogenia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologiaRESUMO
Type B coxsackieviruses (CV-B) frequently infect the central nervous system (CNS) causing neurological diseases notably meningitis and encephalitis. These infections occur principally among newborns and children. Epidemiological studies of patients with nervous system disorders demonstrate the presence of infectious virus, its components, or anti-CV-B antibodies. Some experimental studies conducted in vitro and in vivo support the potential association between CV-B and idiopathic neurodegenerative diseases such as amyotrophic lateral sclerosis and psychiatric illness such as schizophrenia. However, mechanisms explaining how CV-B infections may contribute to the genesis of CNS disorders remain unclear. The proposed mechanisms focus on the immune response following the viral infection as a contributor to pathogenesis. This review describes these epidemiological and experimental studies, the modes of transmission of CV-B with an emphasis on congenital transmission, the routes used by CV-B to reach the brain parenchyma, and plausible mechanisms by which CV-B may induce CNS diseases, with a focus on potential immunopathogenesis.
Assuntos
Encéfalo/virologia , Doenças do Sistema Nervoso Central/virologia , Infecções do Sistema Nervoso Central/virologia , Infecções por Coxsackievirus/diagnóstico , Enterovirus Humano B/isolamento & purificação , Anticorpos Antivirais , Doenças do Sistema Nervoso Central/epidemiologia , Doenças do Sistema Nervoso Central/etiologia , Criança , Infecções por Coxsackievirus/patologia , Enterovirus Humano B/imunologia , Humanos , Recém-NascidoRESUMO
The patient's previously diagnosed dermatologic condition, paired with her recent exposure history, led to the diagnosis in this case.
Assuntos
Infecções por Coxsackievirus/complicações , Eczema/etiologia , Infecções por Coxsackievirus/sangue , Infecções por Coxsackievirus/diagnóstico , Feminino , Humanos , LactenteRESUMO
Hand, foot and mouth disease (HFMD) is a paediatric disease associated with enteroviruses (EVs). Among EVs, coxsackievirus A-16 (CVA-16) strain is currently in circulation and causing outbreaks in India. Neonatal mice (Institute of Cancer Research) strains were infected with CVA-16 strain isolated from HFMD patients to conduct pathological and molecular studies. Infected organs were harvested as per time points. A real-time polymerase chain reaction was used for qualitative estimation of viral RNA in organ tissues of infected mice. Skeletal muscle, brain tissue and cardiac tissues were the major target sites of CVA-16 tropism. The first-ever study was conducted on CVA-16 strains using the current approach in India.
Assuntos
Infecções por Coxsackievirus/virologia , Enterovirus/genética , RNA Viral/análise , Reação em Cadeia da Polimerase em Tempo Real , Animais , Animais Recém-Nascidos , Pré-Escolar , Infecções por Coxsackievirus/diagnóstico , Enterovirus/isolamento & purificação , Enterovirus/patogenicidade , Fezes/virologia , Humanos , Índia , Lactente , Camundongos , Camundongos Endogâmicos ICR , Faringe/virologia , Reto/virologiaRESUMO
The authors present two cases of coxsackie retinopathy that presented with the classic findings of acute outer retinal disruption that evolved to an outer retinal scar. In these two cases, the classic lesions displayed an extramacular distribution. The authors provide detailed multimodal imaging in both cases highlighting the nature of the lesions. It is important to consider coxsackie virus infection in the differential diagnosis of extramacular lesions with outer retinal disruption. The term "unilateral acute idiopathic maculopathy" should be replaced with "coxsackie retinopathy" to better align with the expanded clinical spectrum and the known etiology of this disorder. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:529-532.].
Assuntos
Infecções por Coxsackievirus/diagnóstico , Enterovirus/imunologia , Infecções Oculares Virais/diagnóstico , Angiofluoresceinografia/métodos , Retina/patologia , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica/métodos , Adulto , Anticorpos Antivirais/imunologia , Infecções por Coxsackievirus/virologia , Infecções Oculares Virais/virologia , Feminino , Fundo de Olho , Humanos , Masculino , Doenças Retinianas/virologia , Acuidade VisualAssuntos
Infecções por Coxsackievirus , Degeneração Macular , Doenças Retinianas , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Angiofluoresceinografia , Humanos , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Tomografia de Coerência ÓpticaRESUMO
Viral myocarditis (VMC) is a disease characterized as myocardial parenchyma or interstitium inflammation caused by virus infection, especially Coxsackievirus B3 (CVB3) infection, which has no accurate non-invasive examination for diagnosis and specific drugs for treatment. The mechanism of CVB3-induced VMC may be related to direct myocardial damage of virus infection and extensive damage of abnormal immune response after infection. Non-coding RNA (ncRNA) refers to RNA that is not translated into protein and plays a vital role in many biological processes. There is expanding evidence to reveal that ncRNAs regulate the occurrence and development of VMC, which may provide new treatment or diagnosis targets. In this review, we mainly demonstrate an overview of the potential role of ncRNAs in the pathogenesis, diagnosis and treatment of CVB3-induced VMC.
Assuntos
Infecções por Coxsackievirus , Miocardite , Animais , Infecções por Coxsackievirus/diagnóstico , Modelos Animais de Doenças , Enterovirus Humano B/genética , Camundongos , Camundongos Endogâmicos BALB C , Miocárdio , RNA não Traduzido/genéticaRESUMO
BACKGROUND: Fukuyama congenital muscular dystrophy (FCMD), which is characterized by generalized muscle weakness, hypotonia, and motor delay during early infancy, gradually progresses with advanced age. Although acute rhabdomyolysis following infection in patients with FCMD has occasionally been reported, no studies have investigated rhabdomyolysis following viral infection in FCMD patients during early infancy. CASE REPORT: We report the case of a 50-day-old girl with no apparent symptoms of muscular dystrophy who developed severe acute rhabdomyolysis caused by viral infection, resulting in quadriplegia and respiratory failure therefore requiring mechanical ventilation. Brain magnetic resonance imaging incidentally showed the typical characteristics of FCMD, and FCMD was confirmed by genetic analysis, which revealed a 3-kb retrotransposon insertion in one allele of the fukutin gene and a deep intronic splicing variant in intron 5 in another allele. The virus etiology was confirmed to be Coxsackie A4. CONCLUSION: We report a severe case of acute rhabdomyolysis with the earliest onset of symptoms due to the Coxsackie A4 virus in a patient with FCMD. The present findings indicate that physicians should consider FCMD with viral infection a differential diagnosis if the patient presents with acute rhabdomyolysis following a fever.