Klinički tok infekcije koksakivirusom B (1-6)

Abstract

Objective. Coxsackievirus B (1-6) infections are the common infections of children and adults. Clinical manifestations include fever, aseptic meningitis, pleurodinia, myocarditis, gastroenterocolitis, maculous exanthem. The clinical course of the infection is influenced by the characteristics of the host, as well as the virus serotype. The pathogenesis of the diseases is explained by the immune mediated mechanism and the direct cytotoxic effect of the virus. Methods. Retrospectively analyzed virus serotype, clinical and biochemical data in patients with coxsackievirus B (1-6) infection. Patients who had an unclear febrile condition for more than six months were tested for autoantibodies. Results. We examined a total of 378 patients with coxsackievirus B (1-6) infection (302 women, 76 men), age 19 to 79 years. The dominant symptoms were weakness, elevated body temperature, fatigue and muscle aches. In 55% the clinical course was fever of unknown origin, in 13% myalgia/pleurodinia, 9% acute gastroenterocolitis and acute myocarditis/ pericarditis, 2% aseptic meningitis, 2.4% respiratory disease, 3% acute pancreatitis and 1% diabetes mellitus. Autoantibodies were detected in 69% of patients with fever of unknown origin. Antinuclear antibodies were most common, in 67%. Serotype B2 had 36% of these patients. Serotype B2 had 36% of these patients and serotype B4 had 14%. Conclusion. The most common clinical form of coxsackievirus B (1-6) infection is an fever of unknown origin caused by a B2 serotype of the virus. In most of these patients, an elevated titre of antinuclear antibodies can be detected.