Epidemic pleurodynia is a febrile disorder caused most commonly by a group B coxsackievirus, an enterovirus. Infection causes severe pleuritic chest or abdominal pain.
Epidemic pleurodynia may occur at any age but is most common among children.
(See also Overview of Enterovirus Infections.)
Symptoms of Epidemic Pleurodynia
Severe, frequently intermittent, often pleuritic pain begins suddenly in the epigastrium, abdomen, or lower anterior chest, with fever and often headache, sore throat, and malaise. The involved truncal muscles may become swollen and tender. Symptoms of epidemic pleurodynia usually subside in 2 to 4 days but may recur within a few days and persist or recur for several weeks.
Cases are infrequently complicated by aseptic meningitis, orchitis, and, less commonly, myopericarditis. After recovery, subsequent infection with another group B coxsackievirus is possible.
Diagnosis of Epidemic Pleurodynia
History and physical examination
Diagnosis of epidemic pleurodynia may be obvious in a child who has unexplained severe pleuritic or abdominal pain during an epidemic. However, in other situations, symptoms may be hard to distinguish from those due to other conditions that cause chest or abdominal pain.
Laboratory diagnosis is not routinely necessary; it consists of detecting the virus in a throat or stool sample or, less commonly, demonstrating seroconversion.
Serum creatine kinase is usually elevated because of muscle necrosis. The white cell count ranges from mild leukopenia to mild leukocytosis.
Treatment of Epidemic Pleurodynia
Symptom relief, including nonsteroidal anti-inflammatory drugs (NSAIDs)
Treatment of epidemic pleurodynia includes NSAIDs and other symptomatic measures.
