Bornholm disease history and symptoms

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

The most common presenting symptoms include fever, which affects 70% of patients, which may last 4-7 days.The fever may be associated with headaches. Approximately 40% of patients experience severe, acute chest pain that is described as an iron grip around the rib cage and gives rise to the term referred to as 'The Devil's grip'. Poor oral intake, weakness and muscular fatigue are also commonly found. Although patients recover quickly, relapse is common.

Symptoms may include fever and headache, but the distinguishing characteristic of this disease is attacks of severe pain in the lower chest, often on one side.^[1] The slightest movement of the rib cage causes a sharp increase of pain, which makes it very difficult to breathe, and an attack is therefore quite a frightening experience, although it generally passes off before any actual harm occurs. The attacks are unpredictable and strike "out of the blue" with a feeling like an iron grip around the rib cage. The colloquial names for the disease, such as 'The Devil's grip' reflect this symptom.

Only a few infected people develop the classic muscle pain in the chest and upper abdomen that gives the disease its name. In these people, the coxsackie virus infection has settled in the muscles of the chest and upper abdomen, causing inflammation there. The chest pain usually feels worse with deep breathing, called pleuritic pain. It can be a severe, stabbing pain or it can be a milder cramping in the side. Usually, only one side of the chest or abdomen is affected, although occasionally the pain can include muscles of the neck or arms. The pain usually comes in waves that last 15 to 30 minutes, although some people report having pain episodes that last for several hours. The pain can be so severe that you have trouble breathing, sweat a lot, and become anxious.

• Fever (the most common; presents in 70% of patients)^[2]
  • Often lasts 4-7 days with a temperature of 38°C; some patients may present with a high fever of >39°

• Devil's grip or sudden chest pain (seen in 40% cases)^[3]
  • Pain may be exacerbated by exercise but has also been found to occur with rest^[4]

• Poor oral intake^[5]
• Weakness and fatigue as well as muscular pain^[6]

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