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Clinical manifestations and diagnosis of enterovirus and parechovirus infections

John F Modlin, MD
Section Editors
Martin S Hirsch, MD
Morven S Edwards, MD
Deputy Editor
Allyson Bloom, MD


The human enteroviruses and parechoviruses are ubiquitous viruses found throughout the world, and are transmitted from person to person through fecal-oral contact [1]. Polioviruses, the prototypic enteroviruses, are the cause of paralytic poliomyelitis, a disease that has been eradicated in the United States and other developed countries (except for very rare cases that are attributable to live, attenuated polio vaccine viruses), and that is targeted for worldwide eradication.

The non-polio enteroviruses (group A and B coxsackieviruses, echoviruses, and enteroviruses) and parechoviruses continue to be responsible for a wide spectrum of disease in persons of all ages, although infection and illness occur most commonly in infants and young children.

The clinical manifestations and laboratory diagnosis of enterovirus and parechovirus infections will be reviewed here. The microbiology, epidemiology, pathogenesis, treatment, and prevention of these infections are discussed separately. (See "Epidemiology, pathogenesis, treatment, and prevention of enterovirus and parechovirus infections" and "Poliovirus vaccination".)


More than 90 percent of infections caused by the non-polio enteroviruses are asymptomatic or result only in an undifferentiated febrile illness [2]. When disease occurs, the spectrum and severity of clinical manifestations vary with the age, gender, and immune status of the host. Some clinical syndromes (viral meningitis and some exanthems) are caused by many enterovirus serotypes; others are predominantly caused by certain enterovirus subgroups (eg, pleurodynia and myocarditis due to the group B coxsackieviruses).

The spectrum of diseases attributed to parechoviruses is similar to that of the echoviruses, including fever, respiratory tract infections, exanthems, viral meningitis, encephalitis, myocarditis, and serious neonatal infections [3-10].


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Literature review current through: Mar 2017. | This topic last updated: Sep 30, 2016.
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