A wide variety of rashes occur in association with enteroviral disease, but only 'hand, foot, and mouth disease' is sufficiently characteristic for diagnosis on clinical grounds alone. Patients with epidemic pleurodynia experience spasmodic and paroxysmal chest pain, often without other symptoms or objective findings. This syndrome is commonly confused with other causes of chest pain. Myopericarditis is usually sporadic, and typically presents with dyspnea, chest pain, fever, and malaise. Pain is typically worse with respiration and when lying down.
Some patients report that pain is better when leaning forward.
EKG abnormalities are invariably present, and serum levels of cardiac enzymes are frequently elevated. Conduction abnormalities and cardiac enlargement may occur. Enteroviruses are the most common cause of aseptic meningitis syndrome. Clinical manifestations depend on the age and immune status of the host. Neonates less than 2 weeks of age may develop a very severe meningoencephalitis.