Coxsackie infection and your baby

What is coxsackie infection?

Coxsackie infection is caused by a group of viruses called coxsackie viruses. These viruses usually cause mild illness with flu-like symptoms in young children. But for some children, they can lead to more serious infections.

How can babies get coxsackie infection?

If you have coxsackie infection during pregnancy, you can pass it to your baby during or soon after birth. Your baby also can get coxsackie infection after birth if she has contact with an infected person or contact with germs from an infected person. Coxsackie infection is common during the summer and fall. 

Coxsackie infection can spread to your baby:

• In the air when an infected person sneezes or coughs nearby
• When an infected person sneezes or coughs and touches surfaces like toys with unwashed hands.
• In places like child care centers and schools when other children are infected
• On surfaces contaminated by feces (poop) when someone changes the diaper of an infected baby and then does not wash hands 

What health conditions can coxsackie infection cause in your baby? 

Coxsackie infection may lead to these common health conditions:

• Hand, foot and mouth disease. This condition may cause a skin rash with red spots or blisters on the palms of your baby’s hands, the soles of her feet and around the diaper area. Blisters also may appear in your baby’s mouth on the gums, tongue, inside of the cheek and in the throat. These blisters can make swallowing very painful so your baby may get dehydrated.
• Herpangina. This condition may cause sore throat, fever as well as ulcers and blisters inside the mouth. An ulcer is an open sore or wound. The ulcers are usually white or gray, with a red border around them. The blisters usually have a red border.
• Pink eye (also called conjunctivitis). This is an eye infection that can cause redness, swelling, itching, burning and discharge in the eye.

Coxsackie infection sometimes causes more serious health conditions, especially in newborns. These include: 

• Encephalitis. This is swelling of the brain. It sometimes leads to brain damage and death.
• Hepatitis. This is swelling of the liver. Hepatitis makes the liver stop working well.
• Meningoencephalitis. This is brain tissue infection.
• Myocarditis. This is swelling of the heart muscle. It can lead to heart damage. For newborns, it can cause serious infection and complications, including heart failure and death.
• Viral meningitis. This is infection of the meninges. Meninges are the tissues that cover and protect the brain and the spinal cord.

How do you know if your baby has coxsackie infection?

About half of children who have coxsackie infection have no signs or symptoms. Others may only have a fever.

Tell your baby’s health care provider if your baby has any of these signs and symptoms:

• Being drowsy
• Belly pain or nausea (feeling sick to her stomach)
• Blisters on the skin or in the mouth
• Fever, headache or muscle aches
• Loss of appetite
• Rash
• Sore throat

Your baby’s provider uses a physical exam to check for coxsackie infection. She checks your baby’s skin for rash or blisters and your baby’s mouth for blisters or ulcers. Your baby’s provider also may take a throat culture, blood or samples from your baby’s poop or urine for testing at a lab.

If your baby’s provider thinks she may have a more serious infection caused by coxsackie infection, she may use these medical tests to diagnose it:  

• Cardiac catheterization. During this procedure, your baby’s provider inserts a small tube in your baby’s blood vessels to measure blood pressure and blood flow in and around the heart.
• Chest X-ray. This test makes pictures of your baby’s chest and organs, like the heart and lungs. It can show if the heart is enlarged. It also can show if the lungs have extra blood flow or extra fluid. Extra fluid in the lungs is a sign of heart failure.
• Computerized Tomography scan (also called CT scan). This test is like an X-ray but also uses a computer and shows more detailed images of the body including bones, muscle, fat and organs.
• Electrocardiogram (also called EKG or ECG). This test records how fast the heart is beating and if its rhythm is steady or not. It can show if one of the heart’s chambers is enlarged.
• Magnetic resonance imaging (also called MRI).  This is a medical test that makes a detailed picture of the inside of your body.  
• Spinal tap. This is when your baby’s provider pushes a small needle into your baby’s lower back to remove a small amount of cerebrospinal fluid. Cerebrospinal fluid is found around the brain and spinal cord. You baby’s provider sends the fluid for testing at a lab.

How is coxsackie infection treated?

Your baby’s treatment depends on how serious the infection is. Mild coxsackie infection may last a few days and usually goes away without treatment. 

To help your baby feel better:

• Make sure she gets lots of rest.
• Ask your baby’s provider if you can give your baby acetaminophen (like Tylenol®) or Ibuprofen to help lower her fever and ease any pain from mouth sores or blisters.
• Ask your baby’s provider about giving your baby iced fluids in small amounts.
• Ask your baby’s doctor about anesthetic mouth rinses or sprays that can lessen mouth pain.

If your baby has a serious coxsackie infection or complications, she may need treatment in a hospital.

How long do coxsackie infections last?

The length of infection can vary.  If your baby only has a fever, the temperature can go back to normal within 1 day but on average lasts 3 days. Hand, foot and mouth disease usually lasts for 2 or 3 days. Viral meningitis can take up to 3 to 7 days to clear up. 

How can you keep your baby safe from coxsackie infection?

• Keep your baby away from anyone who’s infected.
• Wash your hands well and often with soap and water, especially after you use the bathroom, after you change your baby’s diaper and before handling any food.
• Clean your baby’s toys, doorknobs and other surfaces often to reduce risk of infection.
• Remind family members to wash their hands.
• Avoid close contact like kissing, hugging or sharing utensils with infected people.
• Talk to your baby’s provider if you think your baby has signs or symptoms of coxsackie infection. 

Last reviewed: October, 2019