Zusammenfassung
Die Bornholmer Krankheit kann zahlreiche differentialdiagnostische Schwierigkeiten
bieten. Je nach dem Sitz der Schmerzen kommen in Betracht: Thorakal: eine Pneumonie
und eine Pleuritis; bei Kleinkindern Croup oder eine Fremdkörperaspiration. Bei Erwachsenen
Interkostal-Neuralgie und Lumbago. Bei vorwiegend abdominaler Form ist die schwierigste
Differentialdiagnose: Appendizitis, ferner Nabelkoliken, Hepatitis epidemica, Gallenblasenentzündung.
Bei der Extremitätenform: Poliomyelitis, Polyarthritis, Muskelrheumatismus, Muskelkater.
— Bei der Meningitis myalgica alle Formen von seröser Meningitis. Bei der seltenen
Komplikation Orchitis und Perikarditis solche anderer Ätiologie. — Bei den Rudimentärformen:
Grippe, Angina, akuter Infekt. Die Diagnose-Möglichkeiten der Bornholmer Krankheit
werden aufgeführt.
Summary
Bornholm disease ist probably caused by Coxsackie virus Al, which predominantly attacks
cross-striated muscle and, therefore, does not lead to permanent paralysis, except
in rare cases. Children and adolescents are especially prone to infection. Incubation
period is 2—5 days. The typical clinical picture consists of a sudden onset of recurrent
paroxysms of chills, fever and perspiration, with severe aches. Dyspnoea and headaches
are prominent. The first paroxysm is usually the worst, the acute stage abating after
a few hours. A repeat attack may occur in a day or two. According to the localization
of complaints, thoracic, abdominal and muscular forms are differentiated. Combined
forms, however, frequently occur. The thoracic form may imitate pneumonia or pleuritis.
In small children, aspiration of foreign bodies or pertussis may be suspected. Even
the incipient stage of respiratory paralysis due to acute poliomyelitis may have to
be excluded. The abdominal form may be mistaken for acute appendicitis, cholecystitis
or hepatitis. Polyarthritis and poliomyelitis are first thought of in the form which
localizes in the extremities and is marked by muscle pains. The disease may be accompanied
by a serous meningitis, in which case its signs and symptoms may dominate the clinical
picture. Orchitis and pericarditis are rare complications. A “rudimentary” stage of
the disease (fever, headaches, myalgia and short-lived chest and abdominal aches)
is particularly difficult to diagnose. The disease occurs most frequently in summer
and autumn. The virus can be isolated from the faeces and complement fixation reaction
and neutralization tests on blood will confirm the diagnosis.
Resumen
Sobre el diagnóstico diferencial de la enfermedad de Bornholm
La enfermedad de Bornholm puede ofrecer numerosas dificultades para el diagnóstico
diferencial. Según la localización de los dolores hay que tener en cuenta: Torácico:
una neumonía y una pleuritis; en niños pequeños, un crup o una aspiración de cuerpos
extraños. En adultos, neuralgia intercostal y lumbago. El diagnóstico diferencial
más difícil es cuando predomina la forma abdominal: »Apendicitis«, además, cólicos
umbilicales, hepatitis epidémica, colecistitis. En las formas extremas: poliomielitis,
poliartritis, reumatismo muscular, agujetas. En la meningitis mialgica, todas los
formas de meningitis serosa. En la complicación rara, orquitis, y pericarditis y algunas
otras de distinta etiología. En las formas rudimentarias: gripe, anginas, infecciones
agudas. Se indican las posibilidades de diagnóstico de la enfermedad de Bornholm.
