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
Malobi I. Ogboli, MBBS, FRCP
Birmingham Children's Hospital and Birmingham City Hospital
MIO declares that she has no competing interests.
Helen Goodyear, MBChB, MRCP, FRCPCH, MD, MMed
HG declares that she has no competing interests.
Andrew Riordan, MD, FRCPCH, MRCP, DTM&H
Consultant in Paediatric Infectious Diseases and Immunology
Royal Liverpool Children's Hospital (Alder Hey)
AR declares that he has no competing interests.
David Cassarino, MD, PhD
Department of Pathology and Laboratory Medicine
University of California
DC declares that he has no competing interests.
Leonid Izikson, MD
Department of Dermatology
Massachusetts General Hospital
LI declares that he has no competing interests.
Aisha Sethi, MD
Assistant Professor of Medicine
Associate Residency Program Director
University of Chicago
AS declares that she has no competing interests.
- 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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