Enteroviruses — clinical association: Coxsackievirus B3 most commonly presents with which of the following conditions?
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AAcute hemorrhagic conjunctivitis
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BMuscular dystrophy
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CMyocarditis
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DGastroenteritis
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EHerpes labialis
Answer
Correct Answer: Myocarditis
Explanation
Introduction / Context:Enteroviruses include polioviruses, Coxsackieviruses (A and B), echoviruses, and others. Each group shows characteristic clinical associations. Coxsackievirus B serotypes are notorious for cardiac involvement, especially myocarditis, which ranges from mild chest discomfort to fulminant heart failure.
Given Data / Assumptions:
- Coxsackievirus B3 is a non-enveloped, positive-sense RNA enterovirus.
- We seek the clinical syndrome most classically linked to Coxsackie B3.
- Differentials include mucocutaneous and ocular conditions attributed to other agents.
Concept / Approach:Coxsackie B viruses (including B3) are strongly associated with myocarditis and pericarditis, as well as pleurodynia (Bornholm disease). While enteroviruses can occasionally cause diarrheal illness, Coxsackie B3’s high-yield association in exams is myocarditis.
Step-by-Step Solution: Match “Coxsackie B3” with cardiac tropism: myocarditis/pericarditis. Exclude options classically caused by other pathogens or groups. Select the single best association: myocarditis.
Verification / Alternative check:Case clusters link Coxsackie B infections to sudden cardiac dysfunction in young adults; pathology shows lymphocytic infiltration of myocardium following viral replication.
Why Other Options Are Wrong:
- Acute hemorrhagic conjunctivitis: Commonly due to Enterovirus 70 or Coxsackie A24 variant, not Coxsackie B3.
- Muscular dystrophy: Genetic disorders, not viral infections.
- Gastroenteritis: Enteroviruses can affect the gut, but B3’s hallmark association is myocarditis.
- Herpes labialis: Caused by herpes simplex virus, not an enterovirus.
Common Pitfalls:Equating all enteroviruses with generic “GI disease”; specific serotypes have distinct tropisms.
Final Answer:Myocarditis is the condition most commonly associated with Coxsackievirus B3.