Bornholm disease pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Bornholm disease is a disease caused by one of the group B coxsackie viruses and is less often caused by a group A coxsackie virus or an echovirus, causing pain in the muscles of the chest that join ribs together. The virus is spread by contact and epidemics usually occur during warm weather in temperate regions and at any time in the tropics, primarily through saliva and feces. From within the pharynx, the viruse multiplies in the throat and intestines, the muscles of the chest wall, abdominal muscles and diaphragm after which it enters the lymphatic tissues. The virus uses autophagy to increase viral replication.

Pathophysiology

Group B coxsackie viruses are transmitted from person to person by fecal-oral contamination, direct mouth-to-mouth contact or via droplet infection. [1] Other people become infected with the virus if they touch contaminated items then put their fingers in their mouth before washing them properly. Contaminated items can include soiled diapers, shared toys and toilets. Epidemic pleurodynia is contagious and occurs in clusters, meaning many people in an area get it around the same time.

The virus that causes devil's grip is a picornavirus. It is spread by contact and epidemics usually occur during warm weather in temperate regions and at any time in the tropics. It can also be spread through saliva and feces.[2] Once inside the body via the pharynx, the coxsackie viruses multiplies in the throat and intestines as well as within the muscles of the chest wall, abdominal muscles and diaphragm after which it enters the lymphatic tissues [3] and subsequently spreads into the bloodstream. At this point, the body's immune defences often can limit the infection and prevent the person from developing symptoms. If the immune defences are less successful, the person starts developing symptoms.

Once viral cells are within host cells, it uses autophagy to increase viral replication. Reduced immunity in children may help explain the disease susceptibility in younger children.[4]

References

  1. JAMIESON WM, PRINSLEY DM (1947). "Bornholm disease in the tropics". Br Med J. 2 (4514): 47–50. doi:10.1136/bmj.2.4514.47. PMC 2055212. PMID 20251794.
  2. http://www.medicomm.net/Consumer%20Site/dc/dc_b60.htm
  3. Lal A, Akhtar J, Isaac S, Mishra AK, Khan MS, Noreldin M; et al. (2018). "Unusual cause of chest pain, Bornholm disease, a forgotten entity; case report and review of literature". Respir Med Case Rep. 25: 270–273. doi:10.1016/j.rmcr.2018.10.005. PMC 6197799. PMID 30364740.
  4. Sin J, Mangale V, Thienphrapa W, Gottlieb RA, Feuer R (2015). "Recent progress in understanding coxsackievirus replication, dissemination, and pathogenesis". Virology. 484: 288–304. doi:10.1016/j.virol.2015.06.006. PMC 4567421. PMID 26142496.

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