Hand-foot-and-mouth disease: Difference between revisions
(added location lesions)
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*Brief prodrome w/ low fever, anorexia, sore mouth
*Brief prodrome w/ low fever, anorexia, sore mouth
*Oral lesions appear 1-2d later
*Oral lesions appear 1-2d later
**Vesicles on erythematous base
**Vesicles on erythematous base, will then ulcerate
**Painful
**Painful
**Found on buccal mucosa, tongue, soft palate and gingiva
*Hand/foot lesions
*Hand/foot lesions
**Red papules that change to gray vesicles
**Red papules that change to gray vesicles

Revision as of 15:35, 31 August 2014

Background

  • Caused by coxsackie virus
  • Most frequently in children, but can occur in all age groups

Clinical Features

Hand lesions coxsackie virus.
Hand lesions coxsackie virus
Hand lesions coxsackie virus.
Hand lesions coxsackie virus
  • Brief prodrome w/ low fever, anorexia, sore mouth
  • Oral lesions appear 1-2d later
    • Vesicles on erythematous base, will then ulcerate
    • Painful
    • Found on buccal mucosa, tongue, soft palate and gingiva
  • Hand/foot lesions
    • Red papules that change to gray vesicles

Differential Diagnosis

Workup

Management

  • No specific therapy for most; self-limited
  • NSAIDS and cool liquids for pain
  • Encourage good hand hygiene to prevent spread
  • Some recommend Magic Mouthwash/oral lidocaine if not tolerating PO intake, although evidence suggests no better than placebo[1]
In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning[2][3]

Disposition

  • Home/Outpatient
  • Resolves after 7–10 days

See Also

Sources

  1. ↑ Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9
  2. ↑ FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm
  3. ↑ Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39
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