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 Southeast 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 in the US, characterized 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
- 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/edema
- 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
- A guide to clinical management and public health response for hand, foot and mouth disease (HFMD)
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