What is the Difference Between Coxsackie A and B?

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Coxsackie A and B viruses are both members of the Enterovirus genus, but they differ in their pathogenicity and the tissues they affect. They are divided into group A and group B viruses based on early observations of their pathogenicity in newborn mice.

  • Coxsackie A: Group A coxsackieviruses primarily affect skeletal and heart muscle, causing infections such as herpangina, hand-foot-and-mouth disease, and acute hemorrhagic conjunctivitis. These viruses are responsible for around 90% of infections caused by non-polio enteroviruses, most of which are asymptomatic or result in self-limiting illnesses.
  • Coxsackie B: Group B coxsackieviruses are associated with a wide range of tissues, including the central nervous system, liver, exocrine pancreas, and brown fat, in addition to striated muscle. They cause infections such as myocarditis, pericarditis, aseptic meningitis, encephalitis, pleurodynia, and hepatitis. Coxsackie B viruses are more likely to cause cardiovascular complications and aseptic meningitis/encephalitis cases.

In general, most Coxsackie infections are asymptomatic and self-limiting, and the majority of the cases are mild illnesses. However, certain Coxsackie viruses can cause more severe complications, especially when infecting newborns or individuals with weakened immune systems.

Comparative Table: Coxsackie A vs B

Coxsackie A and B viruses are both members of the enterovirus group, which is part of the Picornaviridae family. They share some similarities but also have distinct characteristics. Here is a table summarizing the differences between Coxsackie A and B viruses:

Characteristic Coxsackie A Coxsackie B
Number of serotypes 23 serotypes (1-24, with 23 missing) 6 serotypes
RNA clustering Scattered over three RNA clusters (A, B1, and D) Found in RNA clusters B1 and D
Histopathologic lesions Originally classified based on histopathologic lesions in suckling mice Originally classified based on histopathologic lesions in suckling mice
Virus structure Single plus-strand of RNA protected by an icosahedral capsid, no enzymes, no envelope, size 22-30 nm Single plus-strand of RNA protected by an icosahedral capsid, no enzymes, no envelope, size 22-30 nm
Geographic and seasonal distribution Undetermined Undetermined
Clinical features Coxsackie A4, B3, and B4 infections have been studied in children, with varying hospitalization rates, duration of hospitalization, and clinical outcomes Coxsackie B virus infection has been associated with type 1 diabetes

While both Coxsackie A and B viruses share some common features, such as their virus structure and RNA clustering, they differ in the number of serotypes, clinical features, and their association with certain diseases.