Coxsackieviruses Differential Diagnoses

Updated: Feb 02, 2022
  • Author: Martha L Muller, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Diagnostic Considerations

Aseptic meningitis


  • Arboviruses

  • Herpes simplex virus (HSV)

  • Lymphocytic choriomeningitis virus



  • HFMD

    • Herpes simplex: Patients are more ill, have higher fever and cervical adenopathy, and have no lesions on extremities.

    • VZV: Patients are also more ill, rarely have oral lesions, and the palms of the hands and soles of the feet are rarely affected.

  • Herpangina

    • Other viral causes of pharyngitis and bacterial tonsillitis: These do not produce vesicular lesions.

    • Primary herpetic gingivostomatitis: Gingivitis is prominent, and systemic toxicity and cervical lymphadenitis are present; scrapings of lesions do not reveal giant cells or intranuclear inclusions.

    • HFMD: These lesions also occur on extremities.

    • Aphthous stomatitis: Lesions tend to be larger and occur in older children and adults.

Epidemic pleurodynia

Acute hemorrhagic conjunctivitis

  • Adenovirus causing keratoconjunctivitis: The incubation period is 1-3 weeks, whereas the incubation period is 1 day with acute hemorrhagic conjunctivitis (AHC). In addition, subconjunctival hemorrhage is usually not observed with keratoconjunctivitis.

  • Bacterial or chlamydial conjunctivitis must be considered, but these conditions usually do not cause an extensive outbreak.

Differential Diagnoses