Hand, Foot, and Mouth Disease (HFMD)

WHAT IS IT?

Hand, Foot, and Mouth Disease (HFMD) is a common viral illness that usually affects younger children (but can occur in adults sometimes as well).

WHAT CAUSES IT?

Enteroviruses are the cause of this infectious condition:

  • Coxsackievirus A16 is one of the most common causal viruses. With this in mind other coxsackieviruses can also cause HFMD.
  • Enterovirus 71 has also been associated with certain cases of HFMD.

Transmission: an infected individual will shed virus in their secretions (saliva, sputum, nasal) and stool. Contact with infected individuals can cause spread of this virus.

WHY IS IT A PROBLEM?

Infection of this virus can cause the development of unpleasant symptoms (outlined more below).

WHAT MAKES US SUSPECT IT?

Risk factors

Young child (usually under the age of 5), contact with others with suspected/known HFMD

Initial Presentation

Common Chief Complaints:

  • Fever
  • Mouth sores (painful)
  • Skin rash

History Of Present Illness

Other symptoms: malaise, decreased appetite

Physical Exam Findings: It is important to realize that not all patients will have all of the findings below. Some patients may even be asymptomatic despite carrying and transmitting the virus to others.

Vital signs may reveal the presence of a fever.

HEENT exam can show:

  • Herpangia in the mouth: these are painful sores that blister and can become ulcers.

Dermatological exam can show a rash with red spots/blisters. Involved areas can include:

  • Palms/soles of feet
  • Knees/elbows
  • Buttocks/genitals
CLINICAL WORKUP

 

AT WHAT POINT DO WE CONFIDENT IN MAKING THE DIAGNOSIS?

 

WHAT ELSE ARE WE WORRIED ABOUT?

 

HOW DO WE TREAT IT? 

 

HOW WELL DO THE PATIENTS DO?

 

WAS THERE A WAY TO PREVENT IT?

 

OTHER FACTS?

 

FURTHER READING

DynaMed

UpToDate

Centers for Disease Control and Prevention

 

Page Updated: 08.22.2016