Coxsackieviruses Follow-up

Updated: Aug 24, 2018
  • Author: Martha L Muller, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Follow-up

Further Outpatient Care

No outpatient care, other than usual follow-up care, is required for patients with mild symptoms.

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Further Inpatient Care

Severe aseptic meningitis and/or encephalitis, seizures, myopericarditis, and heart failure require admission for workup and treatment. Antibiotics may be used until bacterial meningitis is ruled out. Supportive inpatient or intensive care may be necessary for severe cases.

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Inpatient & Outpatient Medications

Inpatient medications indicated are based on the patient's presentation at admission (eg, phenytoin for seizure prophylaxis and/or suppression in patients with aseptic meningitis/encephalitis, digoxin in patients with heart failure).

Antipyretics (eg, acetaminophen) for fever and NSAIDs for pain should be adequate in patients with mild symptoms who do not require hospital admission.

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Transfer

Transfer to a tertiary facility may be necessary for specialized consultations or surgeries.

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Deterrence/Prevention

Minimize respiratory contact with the infected patient if possible.

To prevent further transmission, strict handwashing should be encouraged and sharing of towels should be avoided.

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Complications

See History and Physical, which discuss the many presentations of coxsackievirus infections.

Complications of aseptic meningitis include lethargy, seizures, coma, and movement disorders (5-10%).

Complications of myopericarditis include pericardial effusion, arrhythmia, heart block, valvular dysfunction, and dilated cardiomyopathy.

Rare complications of acute hemorrhagic conjunctivitis (AHC) include keratitis and motor paralysis.

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Prognosis

In general, the prognosis is very good, with 90% of patients having no symptoms or experiencing mild, self-limited, nonspecific febrile illnesses or rashes.

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Patient Education

Patients should be aware of the need for good hygiene practices to avoid transmission.

Patients need to be reassured that they have a self-limited viral illness that does not require any antibiotics for treatment.

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