Pleurodynia Follow-up

  • Author: Irina Petrache, MD; Chief Editor: Zab Mosenifar, MD   more...
 
Updated: Aug 5, 2011
 

Further Outpatient Care

  • Patients must receive follow-up care with their primary care providers to ensure that other potential coxsackievirus B–associated complications are diagnosed and managed in a timely manner.
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Deterrence/Prevention

  • Common hygiene measures aid in the prevention of the oral-fecal transmission of coxsackievirus B. An outbreak of pleurodynia among high school football players was traced to contaminated water; therefore, avoid direct oral contact with common drinking or ice containers in favor of individual water containers and ice packs.[15]
  • Coxsackievirus B is a small RNA virus that lacks a lipoprotein envelope and, hence, may be resistant to physical and chemical inactivation, including 70% alcohol or 1% quaternary ammonium compounds. Sodium hypochlorite at a concentration of 3120 ppm, at a contact time of 5 minutes, was sufficient to completely inactivate different Enterovirus strains.[16] Good sterilization techniques that include ethylene oxide have been shown to inactivate the virus on electrophysiologic catheters.[17]
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Complications

  • Direct complications of pleurodynia are rare. Splinting from pain may result in atelectasis and shortness of breath.
  • A postviral syndrome, also called fatigue-dysphoria syndrome, is described in children who were seropositive for coxsackievirus B and who complained of fatigue, weakness, sore throats, and dysphoria. This syndrome may also complicate the patient's recovery.
  • In rare cases, coxsackievirus B infection may be complicated by carditis, aseptic meningitis, constrictive pericarditis, orchitis, myalgic encephalomyelitis,[18] hemorrhagic conjunctivitis,[19] hepatitis, pancreatitis,[20] and juvenile-onset diabetes mellitus.
  • Dilated cardiomyopathy is a complication of viral myocarditis. It may be acute or related to severe muscle necrosis, or it may occur several years later, possibly due to chronic inflammation and fibrosis as a result of an immune-mediated process.[21]
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Prognosis

  • The prognosis is good, with complete recovery in most cases. The return to normal health may be gradual after a period of weakness and fatigue. No deaths are reported as a direct result of pleurodynia.
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Patient Education

  • Encourage proper hygiene measures in the patient's household to avoid intrafamilial spread of the virus.
  • For excellent patient education resources, visit eMedicine's Lung and Airway Center. Also, see eMedicine's patient education article Chest Pain.
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Contributor Information and Disclosures
Author

Irina Petrache, MD  Associate Professor of Medicine, Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Occupational Medicine, Indiana University

Irina Petrache, MD is a member of the following medical societies: American Thoracic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Karina A Serban, MD  Fellow, Division of Pulmonary, Allergy, Critical Care and Occupational Medicine, Indiana University Purdue University Indianapolis School of Medicine

Karina A Serban, MD is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Helen M Hollingsworth, MD  Director, Adult Asthma and Allergy Services, Associate Professor, Department of Internal Medicine, Division of Pulmonary and Critical Care, Boston Medical Center

Helen M Hollingsworth, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American Thoracic Society, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gregg T Anders, DO  Medical Director, Great Plains Regional Medical Command , Brooke Army Medical Center; Clinical Associate Professor, Department of Internal Medicine, Division of Pulmonary Disease, University of Texas Health Science Center at San Antonio

Gregg T Anders, DO is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD  Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Ninotchka Liban Sigua, MD, to the development and writing of this article.

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