EXANTHEMATA ASSOCIATED WITH ENTEROVIRAL Infection with any of a number of enteroviruses may be associated with erythematous, macular eruptions. In some patients, occipital and cervical lymphadenopathy may be noted, so that the in-fection may closely simulate rubella. However, differential diagnosis is aided by the frequency of a vesicular ulcerative enanthem and aseptic meningitis in patients with the enteroviral disease and also by its summertime occurrence. Those enteroviruses most frequently associated with rash are the Coxsackie group A viruses 9 and 16, and (quite fortuitously) echoviruses bearing the same numerical designations, i.e., echovirus 9 and echovirus 16).
The eruptions associated with the Coxsackie viruses may include small vesicles, especially notable with Coxsackie A16 (hand, foot, and mouth disease). Echovirus 16 and ‘Coxsackievirus B5 produce eruptions that mimic roseola infantum. The rash seems to be more common in children than in adults. Z&Mi4,” herein, 1. 0., Cherry, J. D., and Finland, eff dric( New viral exanthems. New Eng. J. Med., 269:678, met rived from the passage of virus in African green Wenner, H. A., and Lou, T. Y.: Virus diseases associated via monkey kidney cells. Seroconversion rates after cutaneous eruptions. Progr. Med. Throb, 5:219, 1963.
EXANTHEMATA ASSOCIATED WITH ENTEROVIRAL pitting is generally confined to the face, even in severe cases, and is due to destruction of sebaceous glands followed by organization and subsequent shrinking of granulation tissue and fibrosis. The initial rash is macular and quickly becomes papular. On the eighth or ninth day from the beginning of the rash, drying and crusting begin. The eruption is characteristically more severe on the face and the distal parts of the arms and legs, and least severe over the trunk and abdomen. The groins and axillae may be entirely spared. This centrifugal distribution is distinct from the characteristics of the rash of varicella, which tends to be centripetal.
Lesions are generally found on the palms of the hands and the soles of the feet, a situation uncommonly seen in varicella of childhood, although these parts are often involved in the adult form. The characteristics of pustular lesions of smallpox are round, raised, and tense with a tendency to ventral depression as they begin to dry out. by age, state of immunity, and state of hormonal balance. It is of great interest that women within a short time of term, either before or after delivery, tend to have much more severe disease than those not pregnant. It is no known that the mortality rate is chiefly related to the amount of virus present in. be used as the antigen in the corrie)le-ment-fixation test, the patient will surely die, although death may be delayed for nine or ten days.