Epidemic pleurodynia is a febrile disorder caused most commonly by a group B coxsackievirus, which is 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 of epidemic pleurodynia are infrequently associated with aseptic meningitis, orchitis, and, less commonly, myopericarditis.
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 consists of detecting the virus in a respiratory or stool sample or, less commonly, demonstrating seroconversion.
Serum creatine kinase is usually elevated because of muscle inflammation.
Treatment of Epidemic Pleurodynia
Symptom relief, including nonsteroidal anti-inflammatory drugs (NSAIDs)
Treatment of epidemic pleurodynia includes NSAIDs and other symptomatic measures.
