[5] The slightest movement of the rib cage causes a sharp increase in pain, which makes it difficult to breathe, although it generally passes off before any actual harm occurs.

Maculopapular rashes can also be present with Bornholm disease [3] 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.

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] 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.

[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.

[5] 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.

[10] In a prior case of Bornholm disease the laboratory results showed the white blood cell count, hemoglobin, hematocrit, creatinine, liver function test (LFT), troponin, and creatine kinase (CK) were all within normal limits.

[3] Another uncommon complication is orchitis that manifests as unilateral testicular pain and swelling in the days or weeks following the expected symptoms of Bornholm disease.