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Hand-Foot-and-Mouth Disease

by Mary T. Caserta, MD

Hand-foot-and-mouth disease is a febrile disorder usually caused by coxsackievirus A16, enterovirus 71, or other enteroviruses. Infection causes a vesicular eruption of skin and mucosa.

The disease is most common among young children. The course is similar to that of herpangina (see Herpangina).

Children have a sore throat or mouth pain and may refuse to eat. Fever is common. Vesicles are distributed over the buccal mucosa and tongue, the hands and feet, and, occasionally, the buttocks or genitals; usually, the vesicles are benign and short-lived.

Infection with enterovirus 71 may be accompanied by severe neurologic manifestations (eg, meningitis, encephalitis, polio-like paralysis). Morbidity and mortality are significantly higher with enterovirus 71 than with coxsackievirus A16 or other enteroviruses.

The diagnosis of hand-foot-and-mouth disease is usually made clinically.

Treatment is symptomatic (see Stomatitis : Treatment).

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