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Rash associated with Coxsackie A9 infection
Abstract:
Coxsackie A9 virus was identified by the authors during the fall of 1965 in Montreal in six children with fever and exanthem. Three of the six children were siblings. The exanthem was centrally distributed as described by Lerner et al. and consisted of discrete maculopapules 3 to 4 mm. in diameter. The viral agent was recovered and identified in tissue culture in five cases, while in the sixth Coxsackie type-A lesions were produced in suckling mice. Serological confirmation was obtained in two patients from whom sera were available. In contrast, no exanthem was observed in three older patients with a diagnosis of aseptic meningitis associated with Coxsackie A9 virus. In only one of 16 patients with Coxsackie B virus infection was an exanthem observed during the same period.The true incidence of Coxsackie A9-associated exanthems is difficult to determine because of the benign nature of the disease.
Insights
Coxsackie A9 virus caused fever and rash in children. This viral exanthem is centrally distributed and typically mild, making its exact incidence hard to determine.
Area of Science:
- Virology
- Pediatrics
- Epidemiology
Background:
- Coxsackie A9 virus is known to cause various illnesses.
- Exanthems are common childhood rashes, but specific viral causes can be challenging to identify.
- Previous studies have described Coxsackie virus infections, but the association with specific exanthem types requires further investigation.
Purpose of the Study:
- To identify and characterize the Coxsackie A9 virus in children presenting with fever and exanthem.
- To describe the clinical features and distribution of the rash associated with Coxsackie A9 virus infection.
- To differentiate Coxsackie A9 virus-associated exanthems from other viral infections, including aseptic meningitis and Coxsackie B virus infections.
Main Methods:
- Viral isolation and identification in tissue culture and suckling mice.
- Clinical observation and documentation of exanthem characteristics (distribution, morphology).
- Serological testing for viral confirmation in available patient sera.
- Comparison with cases of aseptic meningitis and Coxsackie B virus infections during the same period.
Main Results:
- Coxsackie A9 virus was identified in six children with fever and a centrally distributed maculopapular exanthem (3-4 mm diameter).
- The virus was successfully recovered in tissue culture (five cases) and via inoculation of suckling mice (one case).
- Serological confirmation was achieved in two patients. No exanthem was noted in three patients with Coxsackie A9 virus-associated aseptic meningitis, and only one of 16 Coxsackie B virus patients had a rash.
Conclusions:
- Coxsackie A9 virus can cause a distinct, centrally distributed exanthem in children.
- The benign nature of this exanthem may lead to underdiagnosis and difficulty in determining its true incidence.
- Distinguishing Coxsackie A9 virus-associated exanthems from other viral illnesses is important for accurate diagnosis and understanding disease spectrum.