Hand, foot and mouth

Question 1

Hand foot and mouth caused by?

Answer 1

Hand, foot and mouth disease is caused by the coxsackie A virus. Incubation is usually 3 – 5 days.

Question 2

Presentation?

Answer 2

The illness starts with typical viral upper respiratory tract symptoms such as tiredness, sore throat, dry cough and raised temperature. After 1 – 2 days small mouth ulcers appear, followed by blistering red spots across the body. As the name suggests, these spots are most notable on the hands, feet and around the mouth. Painful mouth ulcers, particularly on the tongue are also a key feature. The rash may be itchy.

Question 3

Diagnosis + management?

Answer 3

Diagnosis is made based on the clinical appearance of the rash.

There is no treatment for hand, foot and mouth disease. Management is supportive, with adequate fluid intake and simple analgesia such as paracetamol if required. The rash and illness resolve spontaneously without treatment after a week to 10 days

It is highly contagious and advice should be give about measures to avoid transmission, such as avoiding sharing towels and bedding, washing hands and careful handling of dirty nappies.

Question 4

Complications hand, foot + mouth?

Answer 4

Rarely it can cause complications:

Dehydration
Bacterial superinfection
Encephalitis