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Hand-Foot-and-Mouth Disease

Sahil Mullick, FAAFP, MD and Farzad Effan, MBBS Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Common clinical syndrome caused by several enterovirus serotypes

  • Classic appearance of oral enanthem along with exanthem of hands and feet (classically) and potentially located elsewh...

DIAGNOSIS

HISTORY

  • 1- to 2-day prodrome of fever, anorexia, malaise, abdominal pain, upper respiratory symptoms

  • Fever may last 3 to 4 days.

  • Progression of disease divided into 5 stages: rash, neurological...

TREATMENT

  • Symptomatic

  • No current specific antiviral treatments

  • Avoid spicy or acidic foods to limit oral pain.

  • IV fluids may be required in more severe cases of dehydration.

GENERAL MEASURES

Isolation of p...

ONGOING CARE

DIET

  • Encourage cold liquids (e.g., ice cream, popsicles) to prevent dehydration.

  • Avoid acidic, salty, and spicy foods, as they will increase pain.

COMPLICATIONS

  • Dehydration most common due to...

REFERENCES

1
Saguil A, Kane SF, Lauters R, et al. Hand-Foot-and-Mouth Disease: Rapid Evidence Review. Am Fam Physician. 2019;100(7):408-414.
2
Zhu P, Ji W, Li D, et al. Current status of hand-foot-and-mo...

ADDITIONAL READING

Jones E, Pillay TD, Liu F, et al. Outcomes Following Severe Hand Foot and Mouth Disease: A Systematic Review and Meta-Analysis. Eur J Paediatr Neurol. 2018;22(5...

CODES

ICD10

  • B08.4 Enteroviral vesicular stomatitis with exanthem

  • B34.1 Enterovirus infection, unspecified

  • B08.5 Enteroviral vesicular pharyngitis

SNOMED

  • 266108008 hand foot and mouth disease (disorder)

  • 1866...

CLINICAL PEARLS

  • Most common: May to October

  • Children <5 years of age tend to have worse symptoms than older children.

  • HFMD is the most common cause of mouth sores in pediatric patients.

  • Dehydration is...

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