Coxsackie virus: Difference between revisions
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*Coxsackie A virus associated with [[herpangina]] and [[hand-foot-and-mouth disease]] | *Coxsackie A virus associated with [[herpangina]] and [[hand-foot-and-mouth disease]] | ||
*Coxsackie B virus associated with dilated [[cardiomyopathy]] | *Coxsackie B virus associated with dilated [[cardiomyopathy]] | ||
==Clinical Features== | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
===Workup=== | |||
**If unsure, see [[pediatric fever]] | |||
===Diagnosis=== | |||
*Clinical diagnosis, based on history and physical examination | *Clinical diagnosis, based on history and physical examination | ||
==Management== | ==Management== | ||
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*Some recommend Magic Mouthwash/oral lidocaine if not tolerating PO intake, although evidence suggests no better than placebo<ref>Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9</ref> | *Some recommend Magic Mouthwash/oral lidocaine if not tolerating PO intake, although evidence suggests no better than placebo<ref>Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9</ref> | ||
'''In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning'''<ref>FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm</ref><ref>Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39</ref> | '''In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning'''<ref>FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm</ref><ref>Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39</ref> | ||
==Disposition== | ==Disposition== | ||
*Discharge with close outpatient followup to ensure adequate PO intake. | *Discharge with close outpatient followup to ensure adequate PO intake. | ||
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[[Category:ID]] | [[Category:ID]] | ||
[[Category:Pediatrics]] | |||
Latest revision as of 23:45, 31 May 2022
Background
- Spread via the fecal-oral route[1]
- Most common in the summer and fall[2]
- Coxsackie A virus associated with herpangina and hand-foot-and-mouth disease
- Coxsackie B virus associated with dilated cardiomyopathy
Clinical Features
Differential Diagnosis
Pediatric Rash
- Atopic dermatitis
- Bed bugs
- Contact dermatitis
- Drug rash
- Erythema infectiosum (Fifth disease)
- Hand-foot-and-mouth disease
- Henoch-schonlein purpura (HSP)
- Herpangina
- Herpes simplex virus (HSV)
- Infectious mononucleosis
- Meningitis
- Measles
- Molluscum contagiosum
- Roseola infantum
- Rubella (German measles)
- Scabies
- Scarlet fever
- Smallpox
- Varicella (Chickenpox)
Vesiculobullous rashes
Febrile
- Diffuse distribution
- Varicella (chickenpox)
- Smallpox
- Monkeypox
- Disseminated gonococcal disease
- DIC
- Purpural fulminans
- Localized distribution
Afebrile
- Diffuse distribution
- Bullous pemphigoid
- Drug-Induced bullous disorders
- Pemphigus vulgaris
- Phytophotodermatitis
- Erythema multiforme major
- Bullous impetigo
- Localized distribution
- Contact dermatitis
- Herpes zoster (shingles)
- Dyshidrotic eczema
- Burn
- Dermatitis herpetiformis
- Erythema multiforme minor
- Poison Oak, Ivy, Sumac dermatitis
- Bullosis diabeticorum
- Bullous impetigo
- Folliculitis
Evaluation
Workup
- If unsure, see pediatric fever
Diagnosis
- Clinical diagnosis, based on history and physical examination
Management
- No specific therapy for most; self-limited
- NSAIDS and cool liquids for pain
- Encourage good hand hygiene to prevent spread
- Some recommend Magic Mouthwash/oral lidocaine if not tolerating PO intake, although evidence suggests no better than placebo[3]
In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning[4][5]
Disposition
- Discharge with close outpatient followup to ensure adequate PO intake.
See Also
External Links
References
- ↑ Sobolewski B, Mittiga MR, Gonzalez del Rey JA. Pediatric conditions. In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. The Atlas of Emergency Medicine. 4th ed. New York, NY: McGraw-Hill; 2016:(Ch) 14.
- ↑ Sobolewski B, Mittiga MR, Gonzalez del Rey JA. Pediatric conditions. In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. The Atlas of Emergency Medicine. 4th ed. New York, NY: McGraw-Hill; 2016:(Ch) 14.
- ↑ Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9
- ↑ FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm
- ↑ Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39