From the Guidelines
Coxsackie B5 is a type of enterovirus that can cause viral pericarditis, and its treatment is directed to resolve symptoms, prevent complications, and eradicate the virus, with Interferon alpha or beta being a potential treatment option 1.
Key Points
- Coxsackie B5 is a common cause of viral pericarditis, which can lead to inflammation of the pericardium and potentially life-threatening complications.
- The diagnosis of viral pericarditis is not possible without the evaluation of pericardial effusion and/or pericardial/epicardial tissue, preferably by PCR or in-situ hybridisation 1.
- Treatment of Coxsackie B5 pericarditis involves Interferon alpha or beta 2,5 Mio. IU/m2 surface area s.c. 3 per week, as well as management of symptoms and prevention of complications 1.
- Prevention of Coxsackie B5 infection involves good hygiene practices such as thorough handwashing, avoiding close contact with infected individuals, and disinfecting commonly touched surfaces.
- Certain populations, such as newborns, pregnant women, and people with weakened immune systems, are at higher risk for severe illness and complications from Coxsackie B5 infection.
Management and Treatment
- Interferon alpha or beta is a potential treatment option for Coxsackie B5 pericarditis, and its use should be considered in patients with chronic or recurrent symptomatic pericardial effusion and confirmed viral infection 1.
- Management of symptoms, such as fever, headache, and sore throat, is also important, and can be achieved with rest, adequate hydration, and over-the-counter pain relievers like acetaminophen or ibuprofen (follow package dosing instructions).
- Prevention of complications, such as cardiac tamponade, is crucial, and patients with severe symptoms, especially chest pain, difficulty breathing, or extreme lethargy, should seek immediate medical attention.
From the Research
Coxsackie B5 Infection
- Coxsackie virus B5 (CVB5) is a main serotype in human Enterovirus B (EVB) that can cause severe viral encephalitis and aseptic meningitis among infants and children 2.
- There is no approved vaccine or antiviral therapy available against CVB5 infection 2.
Clinical Presentation
- CVB5 infection can present with symptoms such as fever, truncal rash, diarrhea, and splenomegaly with highly elevated ferritin levels in adults 3.
- In newborns, CVB5 infection can cause meningoencephalitis and myocarditis, which can be acquired in utero 4.
- CVB5 infection can also cause myocarditis and dilated cardiomyopathy (DCM) in individuals of all ages 5.
Transmission and Diagnosis
- Viruses can reach the central nervous system (CNS) hematogenously or in a retrograde manner from nerve endings 6.
- Molecular diagnostics technology has helped improve the rate of pathogen detection, reducing unnecessary antibiotic use and length of hospitalization 6.
- CVB5 infection can be diagnosed through isolation of the virus from clinical samples, such as cerebrospinal fluid or stool 4.
Treatment and Prevention
- Most viral infections, including CVB5, have no specific treatment other than supportive care 6.
- Many viruses, including some enteroviruses, are preventable by vaccination and proper skin protection against transmitting vectors 6.
- Further research is needed to develop effective vaccines and therapeutics against CVB5 and other EV-Bs 2.