View source for Coxsackie virus

==Background==
*Spread via the fecal-oral route<ref>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.</ref>
*Most common in the summer and fall<ref>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.</ref>
*Coxsackie A virus associated with [[herpangina]] and [[hand-foot-and-mouth disease]]
*Coxsackie B virus associated with dilated [[cardiomyopathy]]

==Clinical Features==

==Differential Diagnosis==
{{Peds Rash DDX}}
{{Bullous rashes DDX}}

==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<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>

==Disposition==
*Discharge with close outpatient followup to ensure adequate PO intake.

==See Also==
*[[Pediatric fever]]
*[[Hand-foot-and-mouth disease]]
*[[Herpangina]]
*[[Enteroviral Infections]]
*[[Pediatric Rashes]]

==External Links==

==References==
<references/>

[[Category:ID]]
[[Category:Pediatrics]]