eMedicine Specialties > Infectious Diseases > Viral Infections
Echoviruses: Treatment & Medication
Updated: Jun 29, 2006
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Treatment
Medical Care
Antivirals to treat echoviral infections are not available commercially; medical treatment is supportive and symptomatic. Pleconaril, an experimental agent with good in vitro activity against most enteroviruses, is being evaluated in clinical trials and can be obtained for myocarditis, neonatal sepsis, meningoencephalitis, and vaccine-associated polio on a compassionate use basis (call ViroPharma at 610-651-0200). Physicians also use intravenous, intrathecal, and intraventricular gamma globulin with high type-specific antibodies for chronic meningoencephalitis caused by echovirus, but the results are not uniformly effective.
- Chronic meningoencephalitis in hosts who are agammaglobulinemic and other hosts who are immunocompromised
- Intravenous gamma globulin therapy has now replaced immune serum globulin for routine replacement therapy for patients with B-cell immunodeficiency and has been used to treat this disease. This therapy may prove more effective because a much higher serum immunoglobulin G (IgG) concentration can be maintained.
- Use of intravenous immunoglobulin (IGIV) in the treatment of chronic enteroviral meningitis generally has been ineffective, even when using IGIV lots with relatively high concentrations of type-specific antibody. Intrathecal and intraventricular administration of high-titer type-specific antibody preparations have been used, but relapse of infection has occurred even after long-term therapy.
Medication
As noted earlier, no approved drugs for enteroviral infections exist. Pleconaril can be obtained through the manufacturer on a compassionate basis for neonatal sepsis, chronic meningoencephalitis, myocarditis, and enteroviral complications of marrow transplantation and vaccine-associated polio. Call ViroPharma at 610-651-0200 for information/eligibility for this experimental agent.
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| Overview: Echoviruses |
| Differential Diagnoses & Workup: Echoviruses |
Treatment & Medication: Echoviruses |
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References
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CDC. Outbreak of aseptic meningitis associated with multiple enterovirus serotypes--Romania, 1999. MMWR Morb Mortal Wkly Rep. Jul 28 2000;49(29):669-71. [Medline].
Committee on the ECHO Viruses. Enteric cytopathogenic human orphan (ECHO) viruses. Science. 1955;122:1187-8.
Crennan JM, Van Scoy RE, McKenna CH. Echovirus polymyositis in patients with hypogammaglobulinemia. Failure of high-dose intravenous gammaglobulin therapy and review of the literature. Am J Med. Jul 1986;81(1):35-42. [Medline].
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Hall CB, Cherry JD, Hatch MH. The return of Boston exanthem. Echovirus 16 infections in 1974. Am J Dis Child. Mar 1977;131(3):323-6. [Medline].
Haynes RE, Cramblett HG, Kronfol HJ. Echovirus 9 meningoencephalitis in infants and children. JAMA. Jun 2 1969;208(9):1657-60. [Medline].
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Malcom BS, Eiden JJ, Hendley JO. ECHO virus type 9 meningitis simulating tuberculous meningitis. Pediatrics. Apr 1980;65(4):725-6. [Medline].
Modlin JF, Polk BF, Horton P. Perinatal echovirus infection: risk of transmission during a community outbreak. N Engl J Med. Aug 13 1981;305(7):368-71. [Medline].
Spencer FJ. The devil and William Dabney. An epidemiological postscript. JAMA. Feb 21 1966;195(8):645-8. [Medline].
Wilfert CM, Buckley RH, Mohanakumar T. Persistent and fatal central-nervous-system ECHOvirus infections in patients with agammaglobulinemia. N Engl J Med. Jun 30 1977;296(26):1485-9. [Medline].
Further Reading
Keywords
echoviruses, enteroviruses, Enterovirus, Picornaviridae, echovirus viremia, acute aseptic meningitis, encephalitis, viremia rash virus-induced rash, viral respiratory illness, herpangina, epidemic pleurodynia, myopericarditis, meningoencephalitis, viral paralysis, viral paresis, echovirus, echo virus
Treatment & Medication: Echoviruses