Bornholm disease

Bornholm disease, also known as epidemic pleurodynia,^[1] is a condition characterized by myositis of the abdomen or chest caused by the Coxsackie B virus or other viruses.^[2] The myositis manifests as an intermittent stabbing pain in the musculature that is seen primarily in children and young adults.^[3]

It is named after the Danish island of Bornholm in the Baltic Sea where an outbreak was one of the first to be described.

Signs and symptoms

The expected symptoms of Bornholm disease include

Inoculation of throat washings taken from people with this disease into the brains of newborn mice revealed that enteroviruses in the Coxsackie B virus group were likely to be the cause of pleurodynia,^[7] and those findings were supported by subsequent studies of IgM antibody responses measured in serum from people with pleurodynia.^[8] Other viruses in the enterovirus family, including echovirus and Coxsackie A virus, are less frequently associated with pleurodynia.^[9] Echovirus types 1,6,8,9, and 19 and Coxsackie A virus types 4,6,9, and 10 are associated with Bornholm disease. The most common strains causing Bornholm disease are Coxsackie B3 and A9. Viral proliferation in the muscles of the chest wall, diaphragm, and abdomen are thought to contribute to the typical presentation that characterizes the illness.^[10]

Epidemiology

The most common cause of Bornholm disease, Coxsackie B virus, is shed in large amounts in the feces of infected persons and is spread primarily through the fecal-oral route.^[11] Respiratory secretions and oral-oral methods have also shown to be modes of transmission.^[12] In previous cases the disease has been spread by sharing drink containers,^[6] and has been contracted by laboratory personnel working with the virus.^[7] The pharynx is typically the initial site for entering the body, however the virus will proliferate in lymphatic tissues and use the blood stream to reach the muscles and produce symptoms. Preventative measures to decrease transmission of the virus causing Bornholm disease emphasize hand hygiene. In previous studies of Bornholm disease the majority of the patients affected were children.^[5]

Physical exam findings

In a studied case of Bornholm disease the chest pain was unable to be reproduced on palpation and failed to improve with changes in position. The pain was made worse during deep inhalation. A pleural rub was present, however lung auscultation was clear and rashes were absent.^[10]

Laboratory findings and imaging

In a prior case of Bornholm disease the laboratory results showed the

In 1872, Anders Daae and Christian Horrebow Homann reported an epidemic of pleurodynia occurring in the community of Bamble, Norway, giving rise to the name "Bamble disease". Subsequent reports, published only in Norwegian, referred to the disease by this name. Niels Ryberg Finsen also described the disease in Iceland in 1874.^[19] In 1933, Ejnar Sylvest gave a doctoral thesis describing a Danish outbreak of this disease on Bornholm Island entitled "Bornholm disease-myalgia epidemica", and this name has persisted. In 1949 the Coxsackie B virus was isolated and established as an etiology of Bornholm disease.^[14]

Other names

Bornholm disease is also known as Bamble disease,^[14] the devil's grip, devil's grippe, epidemic myalgia, epidemic pleurodynia.^[6]

References