Hand-foot-and-mouth disease is a highly contagious childhood viral infection.
Diagnosis is usually clinical, based on a typical history and characteristic clinical features.
Infection typically resolves spontaneously within 10 to 14 days, and treatment is mainly supportive.
In East and South-east Asian countries, enterovirus 71 (EV71) is responsible for a more severe version of the disease with serious complications; however, this is uncommon in the US and Europe.
A common childhood viral infection that is most commonly caused by a coxsackievirus, characterised by low-grade fever, painful oral ulcers, and vesicles on the hands and feet. The disease has no relation to foot-and-mouth disease, which affects cattle and other cloven-hoofed animals.
History and exam
Key diagnostic factors
- presence of risk factors
- low-grade fever
- oral vesicles and ulcers
- rash and/or vesicles on the hands and feet
Other diagnostic factors
- sore mouth
- loss of appetite
- sore throat
- rash and/or vesicles on the buttocks
- abdominal pain
- tongue erythema/oedema
- age <10 years
- family or school contacts with infection
Investigations to consider
- viral culture
- PCR molecular assays
- Aphthous stomatitis or oral aphthous ulcers
- Herpes simplex
- Health protection in schools and other childcare facilities
- Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)
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