Hand, foot, mouth syndrome

Hand, foot, mouth syndrome (seventh disease) is an enterovirus disease characterized by aphthous stomatitis and exanthema on the acral parts of the body (palms of the hands and soles of the feet).

General Characteristics

 * Generators: enteroviruses (mainly Coxsackie A16, Enterovirus 71, or Coxsackie virus B2 and B5).
 * Source and transmission: droplet and orofecal.
 * Incubation period: 3-6 days'.
 * Seasonal occurrence: maximum occurrence in the summer months.
 * High contagiousness - often siblings are also sick.

Clinical picture
Prodromes may be absent or non-specific symptoms may appear: increased temperature, pain in the throat and abdomen. Subsequently, the disease itself manifests itself:


 * aphthous stomatitis - aphthae in the area of the oral cavity (the eruption is very painful and the child may refuse to eat and drink because of the pain);
 * exanthema on the distal parts of the limbs, on the palms, soles, backs of the hands and feet;
 * fever lasting approximately 2 days.

Exanthema blisters appear more on the extensor area than over the flexors of the limbs. Blisters subsequently turn into crusts and erosions with a red border may itch.

Differential diagnosis
In a patient with hand-foot-mouth syndrome, we further consider the following diseases:


 * chickenpox,
 * impetigo,
 * herpetic gingivostomatitis,
 * herpangina,
 * Kawasaki syndrome.

Diagnosis, therapy, prognosis
We monitor the clinical symptoms and as a confirmation the 'enterovirus serology is examined. Patients are usually treated for 10 days, the therapy is only symptomatic. The disease is often 'without complications, theoretically serous meningitis could occur.