Hand, Foot and Mouth disease

Clinical

• Coxsackie virus (more serious Enteroviuus clusters in Asia)
• Person to person spread.
• Max children 1 - 4 years (common up to 10 years).
• Sores in mouth, rashes on hands & feet and buttocks.
  • "Textbook" vesicles occur at junction of hard and soft skin (palm, sole/ankle area).
• Commonest cause mouth sores (painful, small yellow sores, red halo) children.
• Painful eating then hand rash.
• May have low fever, anorexia, sore throat, abdo. pain for 7 days.
• Usually mild but beware dehydration and occasional arthropathy.
• Clinical diagnosis.
• Rarely progress to encephalitis / transverse myelitis (flaccid - so do neuro exam).
• Hydration, analgesia (mouth ulcers), control pyrexia.
• Keep from school only if ill (may attend school if rash alone).

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