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__NOTOC__
{{Hand-foot-and-mouth disease}}
{{Hand-foot-and-mouth disease}}
{{CMG}}


==Prognosis==
{{CMG}}; {{AE}} {{YK}}, {{AKI}}
Generally, complete recovery occurs in 5 to 7 days.


==Complications==
==Overview==
The outbreaks of [[Hand-foot-and-mouth disease|hand foot mouth disease]] occur during the period of warm temperatures of spring, summer, and fall, showing a strong seasonal pattern. [[Hand-foot-and-mouth disease|Hand foot mouth disease]] affects [[infants]] and children, and is quite common.The symptoms appear within 3 days to 1 week after the infection with mild [[fever]], [[poor appetite]], [[malaise]] and [[sore throat]], followed by development of painful sores develop in the mouth. It is a self limiting condition but few patients might develop complications such as [[pulmonary hemorrhage]] and [[meningitis]].
 
==Natural History, Complications and Prognosis==
 
===Natural History===
The outbreaks of [[Hand-foot-and-mouth disease|hand foot mouth disease]] occur during the period of warm temperatures of spring, summer, and fall, showing a strong seasonal pattern.<ref name="pmid28063653">{{cite journal| author=Nguyen HX, Chu C, Nguyen HL, Nguyen HT, Do CM, Rutherford S et al.| title=Temporal and spatial analysis of hand, foot, and mouth disease in relation to climate factors: A study in the Mekong Delta region, Vietnam. | journal=Sci Total Environ | year= 2017 | volume= 581-582 | issue=  | pages= 766-772 | pmid=28063653 | doi=10.1016/j.scitotenv.2017.01.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28063653  }} </ref> [[Hand-foot-and-mouth disease|Hand foot mouth disease]] affects [[infants]] and children, and is quite common. It is highly [[contagious]] and is spread through direct contact with the [[mucus]] or [[feces]] of an infected person. [[Transmission]] is by direct contact with [[nose]] and [[throat]] discharges, [[saliva]], fluid from blisters, or [[stools]] of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months.The symptoms appear within 3 days to 1 week after the infection with mild [[fever]], [[poor appetite]], [[malaise]] and [[sore throat]], followed by development of painful sores develop in the [[mouth]]. The mouth [[ulcers]] are usually seen on the [[tongue]], [[gums]], and inside of the cheeks. The [[skin rash]] develops over 1 to 2 days as a flat red patch with [[Blister|blisters]] on the [[Palms of the hands|palms]] and [[foot]]. [[Hand-foot-and-mouth disease|Hand foot mouth disease]] usually resolves in a week to 10 days, but very rarely complications such as [[meningitis]] and acute [[flaccid]] [[paralysis]] can occur.
 
===Complications===
Complications of hand foot and mouth disease include:
*[[viral meningitis|Viral]] or [[aseptic meningitis]], it presents with [[fever]], [[headache]], [[stiff neck]], or [[back pain]].<ref name="pmid27826325">{{cite journal| author=Lee KY| title=Enterovirus 71 infection and neurological complications. | journal=Korean J Pediatr | year= 2016 | volume= 59 | issue= 10 | pages= 395-401 | pmid=27826325 | doi=10.3345/kjp.2016.59.10.395 | pmc=5099286 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27826325  }} </ref>
*[[Encephalitis]]
*A [[polio]]-like [[paralysis]]
*Fingernail and toenail loss, usually occurs mostly in children within 4 weeks of having hand [[Foot-and-mouth disease|foot and mouth disease]]. However, the nail loss has been temporary and nail growth resumed without medical treatment.<ref>http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm#10</ref><ref name="pmid28246241">{{cite journal| author=Gan XL, Zhang TD| title=Onychomadesis after hand-foot-and-mouth disease. | journal=CMAJ | year= 2017 | volume= 189 | issue= 7 | pages= E279 | pmid=28246241 | doi=10.1503/cmaj.160388 | pmc=5318214 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28246241  }} </ref>
*Acute flaccid [[paralysis]])
*Cardiopulmonary failure<ref name="pmid27001010">{{cite journal| author=Long L, Xu L, Xiao Z, Hu S, Luo R, Wang H et al.| title=Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease. | journal=Sci Rep | year= 2016 | volume= 6 | issue=  | pages= 23444 | pmid=27001010 | doi=10.1038/srep23444 | pmc=4802311 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27001010  }} </ref>
*[[Pulmonary edema]] or [[pulmonary hemorrhage]]<ref name="pmid25861335">{{cite journal| author=Lee DS, Lee YI, Ahn JB, Kim MJ, Kim JH, Kim NH et al.| title=Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease. | journal=Korean J Pediatr | year= 2015 | volume= 58 | issue= 3 | pages= 112-5 | pmid=25861335 | doi=10.3345/kjp.2015.58.3.112 | pmc=4388973 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25861335  }} </ref><ref name="pmid26138417">{{cite journal| author=Zhou L, Li Y, Mai Z, Qiang X, Wang S, Yu T et al.| title=[Clinical feature of severe hand, foot and mouth disease with acute pulmonary edema in pediatric patients]. | journal=Zhonghua Wei Zhong Bing Ji Jiu Yi Xue | year= 2015 | volume= 27 | issue= 7 | pages= 563-7 | pmid=26138417 | doi=10.3760/cma.j.issn.2095-4352.2015.07.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26138417  }} </ref>
*[[Acute pancreatitis]]<ref name="pmid26877620">{{cite journal| author=Zhang YF, Deng HL, Fu J, Zhang Y, Wei JQ| title=Pancreatitis in hand-foot-and-mouth disease caused by enterovirus 71. | journal=World J Gastroenterol | year= 2016 | volume= 22 | issue= 6 | pages= 2149-52 | pmid=26877620 | doi=10.3748/wjg.v22.i6.2149 | pmc=4726688 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26877620  }} </ref>
 
===Prognosis===
[[Hand-foot-and-mouth disease|Hand foot mouth disease]] is a self limiting disease and complete recovery occurs in 5 to 7 days. In very few patients prognosis is poor with the development of p[[Pulmonary hemorrhage|ulmonary hemorrhage]], hypotension and elevated serum [[lactate]].<ref name="pmid25344186">{{cite journal| author=Song CL, Cheng YB, Chen D, Gu X, Li HB, Yan XQ| title=[Risk factors for death in children with severe hand, foot and mouth disease]. | journal=Zhongguo Dang Dai Er Ke Za Zhi | year= 2014 | volume= 16 | issue= 10 | pages= 1033-6 | pmid=25344186 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25344186  }} </ref>


* Complications from the virus infections that cause HFMD are not common, but if they do occur, medical care should be sought.
* Viral or aseptic meningitis can rarely occur with HFMD. Viral meningitis causes fever, headache, stiff neck, or back pain. The condition is usually mild and clears without treatment; however, some patients may need to be hospitalized for a short time.
* Other more serious diseases, such as encephalitis (swelling of the brain), a polio-like paralysis, result even more rarely. Encephalitis can be fatal.
* There have been reports of fingernail and toenail loss occurring mostly in children within 4 weeks of their having hand, foot, and mouth disease (HFMD). At this time, it is not known whether the reported nail loss is or is not a result of the infection. However, in the reports reviewed, the nail loss has been temporary and nail growth resumed without medical treatment.<ref>http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm#10</ref>
* Other complications include ([[encephalitis]], [[meningitis]] or [[acute flaccid paralysis]]) or [[pulmonary edema]]/[[pulmonary hemorrhage]].
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Pediatrics]]
[[Category:Viral diseases]]
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[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Dermatology]]
[[Category:Otolaryngology]]

Latest revision as of 21:57, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2], Aravind Kuchkuntla, M.B.B.S[3]

Overview

The outbreaks of hand foot mouth disease occur during the period of warm temperatures of spring, summer, and fall, showing a strong seasonal pattern. Hand foot mouth disease affects infants and children, and is quite common.The symptoms appear within 3 days to 1 week after the infection with mild fever, poor appetite, malaise and sore throat, followed by development of painful sores develop in the mouth. It is a self limiting condition but few patients might develop complications such as pulmonary hemorrhage and meningitis.

Natural History, Complications and Prognosis

Natural History

The outbreaks of hand foot mouth disease occur during the period of warm temperatures of spring, summer, and fall, showing a strong seasonal pattern.[1] Hand foot mouth disease affects infants and children, and is quite common. It is highly contagious and is spread through direct contact with the mucus or feces of an infected person. Transmission is by direct contact with nose and throat discharges, saliva, fluid from blisters, or stools of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months.The symptoms appear within 3 days to 1 week after the infection with mild fever, poor appetite, malaise and sore throat, followed by development of painful sores develop in the mouth. The mouth ulcers are usually seen on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days as a flat red patch with blisters on the palms and foot. Hand foot mouth disease usually resolves in a week to 10 days, but very rarely complications such as meningitis and acute flaccid paralysis can occur.

Complications

Complications of hand foot and mouth disease include:

Prognosis

Hand foot mouth disease is a self limiting disease and complete recovery occurs in 5 to 7 days. In very few patients prognosis is poor with the development of pulmonary hemorrhage, hypotension and elevated serum lactate.[9]

References

  1. Nguyen HX, Chu C, Nguyen HL, Nguyen HT, Do CM, Rutherford S; et al. (2017). "Temporal and spatial analysis of hand, foot, and mouth disease in relation to climate factors: A study in the Mekong Delta region, Vietnam". Sci Total Environ. 581-582: 766–772. doi:10.1016/j.scitotenv.2017.01.006. PMID 28063653.
  2. Lee KY (2016). "Enterovirus 71 infection and neurological complications". Korean J Pediatr. 59 (10): 395–401. doi:10.3345/kjp.2016.59.10.395. PMC 5099286. PMID 27826325.
  3. http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm#10
  4. Gan XL, Zhang TD (2017). "Onychomadesis after hand-foot-and-mouth disease". CMAJ. 189 (7): E279. doi:10.1503/cmaj.160388. PMC 5318214. PMID 28246241.
  5. Long L, Xu L, Xiao Z, Hu S, Luo R, Wang H; et al. (2016). "Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease". Sci Rep. 6: 23444. doi:10.1038/srep23444. PMC 4802311. PMID 27001010.
  6. Lee DS, Lee YI, Ahn JB, Kim MJ, Kim JH, Kim NH; et al. (2015). "Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease". Korean J Pediatr. 58 (3): 112–5. doi:10.3345/kjp.2015.58.3.112. PMC 4388973. PMID 25861335.
  7. Zhou L, Li Y, Mai Z, Qiang X, Wang S, Yu T; et al. (2015). "[Clinical feature of severe hand, foot and mouth disease with acute pulmonary edema in pediatric patients]". Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 27 (7): 563–7. doi:10.3760/cma.j.issn.2095-4352.2015.07.005. PMID 26138417.
  8. Zhang YF, Deng HL, Fu J, Zhang Y, Wei JQ (2016). "Pancreatitis in hand-foot-and-mouth disease caused by enterovirus 71". World J Gastroenterol. 22 (6): 2149–52. doi:10.3748/wjg.v22.i6.2149. PMC 4726688. PMID 26877620.
  9. Song CL, Cheng YB, Chen D, Gu X, Li HB, Yan XQ (2014). "[Risk factors for death in children with severe hand, foot and mouth disease]". Zhongguo Dang Dai Er Ke Za Zhi. 16 (10): 1033–6. PMID 25344186.

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