Coxsackie virus


Clinical Features

Differential Diagnosis

Pediatric Rash

Vesiculobullous rashes




  • Clinical diagnosis, based on history and physical examination


  • 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]


  • Discharge with close outpatient followup to ensure adequate PO intake.

See Also

External Links


  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.
  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