Bornholm disease differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S


Bornholm Disease has been referred to by various different names, some of which include Devil's Grip, epidemic pleurodynia and epidemic myalgia, to name a few. Apart from the plethora of names presenting possible difficulty in its recognition, it is often a diagnosis that is not part of the initial differential diagnosis' when a patient presents with chest pain. Because of the possibility of life-threatening conditions presenting with similar pain, it often requires extensive workup to exclude other diseases in medical settings.

Differential Diagnosis

Bornholm disease presents with acute chest and or abdominal pain and requires a high degree of suspicion for diagnosis. The disease presents with a. clinical syndrome that can appear to mimic inflammation or injury of any organ within the thorax or abdomen and thus requires differentiation.[1]

Differential Diagnosis for Bornholm Disease[1]
Condition Common Presenting Symptoms Workup to differentiate conditions from Bornholm Disease
Acute Coronary syndromes (ACS) ACS is a spectrum of cardiac conditions that include angina, STEMI and NSTEMI.

Symptoms include:

Aortic dissection/ Ruptured aortic aneurysm
Pulmonary embolism (PE)
Tension pneumothorax  
Pleurisy/ Pleuritis
  • Chest pain worse on palpation and inspiration. Often radiates to the arm and or back
  • Dyspnea
Acute appendicitis
Guillain-Barré Syndrome[2]


  1. 1.0 1.1 Lal A, Akhtar J, Isaac S, Mishra AK, Khan MS, Noreldin M; et al. (2018). "Unusual cause of chest pain, Bornholm disease, a forgotten entity; case report and review of literature". Respir Med Case Rep. 25 ( ): 270–273. doi:10.1016/j.rmcr.2018.10.005. PMC 6197799. PMID 30364740.
  2. Orimo K, Hatano K, Sato N, Okabe S, Suzuki A, Mori K; et al. (2020). "Clinical Characteristics of Epidemic Myalgia Associated with Human Parechovirus Type 3 during the Summer of 2019". Intern Med. 59 (14): 1721–1726. doi:10.2169/internalmedicine.4416-20. PMC 7434534 Check |pmc= value (help). PMID 32296005 Check |pmid= value (help).

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