Enteroviruses Differential Diagnoses

Updated: Mar 01, 2018
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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DDx

Diagnostic Considerations

Acute hemorrhagic conjunctivitis

Adenovirus keratoconjunctivitis

Gonococcal conjunctivitis

Myopericarditis

Acute myocardial infarction

Angina

Ischemic and nonischemic cardiomyopathy

Other viral pericarditis

Aseptic meningitis

Arbovirus infection

Lyme disease

Rocky Mountain spotted fever

Ehrlichiosis

Incompletely treated bacterial meningitis

Syphilis

Tuberculosis meningitis

Sarcoidosis

Hand-foot-and-mouth disease

Herpes simplex

Aphthous stomatitis

Erythema multiforme

Atypical varicella

Abortive polio

Aseptic meningitis

Paralytic polio

Guillain-Barré syndrome

Botulism

Arthropod-borne viral encephalitis

Herpangina

Bacterial tonsillitis

Aphthous stomatitis

Other viral tonsillitis

Oral herpes simplex infections

Pleurodynia

Pneumonia

Pulmonary infarction

Rib fracture

Costochondritis

Herniated intervertebral disc

Renal colic

Myocardial infarction

Prodromal phase of zoster

Acute abdomen

Empyema

Guillain-Barré syndrome is an acute demyelinating polyneuropathy and, in the postpolio era, is the most common cause of generalized paralysis. The major symptom is rapidly progressive paralysis, which, unlike in polio, is symmetrical. Paralysis of the lower extremities is followed by paralysis of the upper extremities, and both proximal and distal muscle groups are involved. Deep tendon reflexes are initially reduced and are later absent. A mild sensory disturbance or paresthesia occurs. The cerebrospinal fluid (CSF) typically has an elevated protein level and a normal cell count (albuminocytologic dissociation).

The cutaneous manifestations of human enterovirus infections include widespread blistering mucocutaneous reactions without any suspected drug causality. [55] A new variant of coxsackievirus A6 has been identified in the Republic of China as the causative agent for severe mucocutaneous blistering reactions similar to what one may see with severe cutaneous adverse reactions, characterized as resembling the Stevens-Johnson syndrome complete with erythema multiform–like plaques. In addition, the histologic patterns was that of erythema multiforme major/Stevens-Johnson syndrome.

Differential Diagnoses