Hand-foot-and-mouth disease: Difference between revisions

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*Caused by coxsackie virus
*Caused by coxsackie virus
*Most frequently in children, but can occur in all age groups
*Most frequently in children, but can occur in all age groups
*Similar to [[Herpangina]], but with additional hand/foot lesions


==Clinical Features==
==Clinical Features==
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==Differential Diagnosis==
==Differential Diagnosis==
*[[Herpangina]]
{{Peds Rash DDX}}
*See also [[Pediatric Rashes]]


==Workup==
==Workup==

Revision as of 19:00, 3 January 2015

Background

  • Caused by coxsackie virus
  • Most frequently in children, but can occur in all age groups
  • Similar to Herpangina, but with additional hand/foot lesions

Clinical Features

Hand lesions coxsackie virus.
Hand lesions
Foot lesions
  • 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

Pediatric Rash

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

Complications

  • Some children get a desquamation of the nails around 2 weeks afterwards (self resolves)

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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