The syndrome of " hand-foot - mouth" - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

name syndrome "hand-foot-mouth" (or hand, foot and mouth disease with exanthema) comes from the English Hand-Foot-and-Mouth Disease (HFMD) and presented a syndrome consisting of lesions of oral mucosa - enantemy and appearance of the rashon the upper and lower extremities - exanthema.It is one of the options "enterovirus infection", namely Boston exanthema.

Pathogens syndrome "hand-foot-mouth»: enteroviruses Coxsackie A16, A5, A10, A9, B1, B3, enterovirus 71. This RNA-containing viruses, fairly stable in the environment that can be stored at room temperature for up to 2weeks in a viable state.


These viruses are widespread among people of all ages, but most often affects children under 3 years.Adults get sick less often and carry the infection is also favorable.

disease is recorded in most cases in the summer-autumn period. mechanisms infection - aerogenic (airborne route of transmission) and the fecal-oral mechanism. transmission factors can be the items, such as toys, tablewa

re, pastel and hygiene items.But more often infection occurs when you sneeze, cough or simple conversation.Contagious is not only sick people but also healthy carriers of enteroviruses.

Immunity after past infection formed type-specific, persistent (ie, life).However, if a person is infected by another serotype of enterovirus (eg, ill with A 16, and re-infected B3), the disease can recur.

symptoms of enteroviral stomatitis with exanthema (syndrome of hand-foot-mouth)

incubation period (from the time of infection until the first signs of the syndrome) lasts 4-7 days.The patient becomes infectious from the first symptoms of the disease and remains so all the height of the disease.The first symptom is the increase in temperature to 37,5-38º, intoxication symptoms - weakness, headache, sore throat, muscle aches.The duration of fever up to 3-5 days.That is the beginning of the disease is very similar to SARS.However, unlike SARS 1-2 days on the palms of hands (sometimes back of the hand) and the feet (the soles more), at least at the back of the thighs and buttocks, rash appears as small vesicles * 3 mm in diameter, surroundedwhisk redness (* vesicle - cavity element with transparent content, towering above the surface of normal skin, which has a ring around it, or whisk redness).The dynamics of development of rash opposite occurs: the elements are not opened, the contents of their disappearing, there comparing it with the normal surface of the skin, redness disappears.The rash lasts from a patient for 5-7 days, then disappears without a trace.

rash on the palms and feet of a child with the syndrome of hand-foot-mouth

Syndrome of hand-foot-mouth, rash on the palms and feet

ruka- Syndromefoot-mouth, rash on the feet of the child

Simultaneously with the appearance of a rash in the mouth appear ulcers (or sprue), accompanied by tenderness, sensitivity to hot, spicy food.Aphthous stomatitis phenomena can be detected on the inner surface of the cheeks, tongue, gums, hard and soft palate.When stomatitis decreased appetite, there is irritability, moodiness, there may be pain in the throat, having difficulty in eating, excessive salivation.

Enterovirus stomatitis in a child with the syndrome of hand-foot-mouth

Unlike gerpanginy (another embodiment of enterovirus infection, which in a process involving the tonsils), the syndrome of "hand-foot-mouth" sores do not come to the surfacetonsils.

pathogenesis has not been proved in the English-speaking sources there are indications that in 1-2 months after suffering a syndrome patients may experience failure (delamination) nails this relationship.

syndrome Complications hand-foot-mouth

Most often the disease favorable prognosis , spontaneously recover.However, the "hand-foot-mouth" can be terrible and severe complications of the syndrome at infection with enterovirus 71.Perhaps the development of meningitis (inflammation of the pia mater), encephalitis (inflammation of the brain tissue), of which more details can be found in the article "enterovirus infection".

Anxiety symptoms in the syndrome of "hand-foot-mouth", which will allow suspected adverse course of the disease and require medical emergencies: temperature rise above 39º, persistent high fever, the appearance of vomiting, sometimes repeated, increasing headache, painin eyeballs, constant crying and capricious child on the background of fever, constant drowsiness, or vice versa patient psychomotor agitation. When symptoms such delay in medical care can cost a patient's life.

Syndrome Diagnosis "hand-foot-mouth»

Usually, the diagnosis is based on clinical presentation and exclusion of infectious diseases with a characteristic rash (chickenpox, rubella, measles).Support diagnostic features the following:
- beginning with a small fever and intoxication;
- after 1-2 days the appearance of exanthema (rash with blisters) on the feet, hands (palms);
- simultaneous appearance enantemy (stomatitis phenomena) in the mouth;
- the absence of specific syndromes other infectious diseases (angina, pulmonary syndrome, pronounced lesions of the lymphatic system and other).

Secondary endpoints are laboratory methods (anaziz taken in the development of complications): complete blood count with typical criteria of a viral infection (possible leukocytosis, an increase of lymphocytes, decreased neutrophils, ESR usually within the normal range).Specific laboratory methods to confirm the nature of the enterovirus syndrome - a virological method (isolation of enteroviruses in the swabs and smears from the pharynx), serological blood tests (detection of specific antibodies in the serum of patients blood).

Treatment syndrome "hand-foot-mouth»

With a favorable course of the disease (the vast majority of patients) the symptoms disappear on their own within a week, at least 9-10 days.

1) Organizational-regime activities. Most require treatment on an outpatient basis (at home).Showed a special diet - balanced diet with mechanical and chemical sparing, that is, the food should be in the form of heat, liquid or semi-liquid, eliminate too salty, spicy, hot food.Must keep drinking regime for removing toxins from the body, reduce fever (according to age enough fluids).

2) Drug therapy is both causal and symptomatic:
- interferon inducers (anaferon children and adults, aflubin and others);
- fever temperature - Nurofen, Panadol, efferalgan and others, avoid taking aspirin to prevent occurrence of Reye's syndrome;
- antihistamines with rash - Claritin, zodak, tsetrin and others.

3) Local therapy (gargling with warm soda solution and sage, chlorhexidine solutions furatsillina, Tantum Verde spray, panthenol spray for the prevention of secondary bacterial infection immudon resorption)

prevention syndrome "hand-foot-mouth»

1) Avoid contact with sneezing and coughing people.
2) Compliance with the rules of personal hygiene - hand washing, oral hygiene.
3) If you are caring for a sick and processing elements of the rash use protective equipment (gloves).

infectious disease doctor Bykov NI

According herpetic Center, Russian Academy of Medical and Technical Sciences, hand-foot syndrome, mouth can be caused by enteroviruses in conjunction with EBV, CMV and HHV№6 (in other words persestiruyuschey with herpes infection), which aggravates the course of disease.