Hand-foot-and-mouth disease
Background
- Caused by coxsackie virus
- Most frequently in children, but can occur in all age groups
Clinical Features
- Brief prodrome w/ low fever, anorexia, sore mouth
- Oral lesions appear 1-2d later
- Vesicles on erythematous base
- Painful
- Hand/foot lesions
- Red papules that change to gray vesicles
Differential Diagnosis
- Herpangina
- See also Pediatric Rashes
Workup
- None (clinical diagnosis)
- If unsure, see Pediatric Fever
Management
- No specific therapy for most, self-limited
- Consider Magic Mouthwash if not tolerating PO intake although evidence suggests no better than placebo[1]
- NSAIDS and cool liquids for pain
- Encourage good hand hygiene to prevent spread
- In infants DO NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning[2]
Disposition
- Home/Outpatient
- Resolves after 7–10 days
See Also
Sources
- ↑ 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
- ↑ FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm