Primary viremia spreads the viruses to their targert tissue.
The viruses are cytolytic, causing direct damage to their target cells. Syndromes associated particularly with Coxsackie B virus are pleurodynia, also known as Bornholm disease or devil's grippe, which presents with severe pleuritic chest pain, sometimes accompanied by abdominal pain and vomiting, asceptic meningitis, colds, and myocardial or pericardial infections.