Hand,
Foot, and Mouth Syndrome
DEFINITION:
A viral illness causing mouth sores and a rash on the hands
and feet.
SYMPTOMS:
Painful
sores in the mouth along with red vesicles on the hands, feet
and sometimes on the buttocks.
CAUSES:
A
virus called coxsackievirus A16.
DIAGNOSIS:
The
diagnosis is made clinically. A combination of ulcers in the
mouth plus the vesicular rash on the hands, feet or buttocks
will prompt the diagnosis of hand, foot, and mouth syndrome.
CONTAGION:
This
illness is highly contagious. The virus is in the mouth and
can be spread by contact with saliva. The incubation period
is four to six days.
TREATMENT:
Treatment
consists of pain relief. Using acetaminophen (Tylenol, Tempra)
or ibuprofen (Motrin, Advil) can do this. An antacid can be
swished in the mouth and spit out. A physician may prescribe
a medicine containing diphenhydramine (Benadryl), an antacid
(Maalox, Mylanta) and viscous lidocaine, which can numb the
area. An oral rinse with chlorhexidine (Peridex) can provide
some relief. Triamcinolone (Kenalog) dental paste is a steroid
that can reduce swelling and be of some help. The lesions
will resolve spontaneously in one to two weeks.
DISCUSSION:
Hand,
foot, and mouth syndrome causes very painful ulcers in the
mouth in combination with red spots or vesicles on the hands
and feet. The rash is frequently found on the buttocks as
well. The ulcers are similar to canker
sores and will follow the same course. Once diagnosed,
there is no cure, but this will resolve spontaneously in one
to two weeks. Pain control is the best medicine. Using topical
medicine in the mouth that can cover, numb or shrink inflammation
of the sores helps with this. Certain foods can be very painful
including spicy foods, salty foods, or citrus juices. Once
this illness has presented, it has a tendency to recur. Recurrence
usually comes periodically. It is initiated by another illness
such as an upper respiratory infection or it can be brought
on by stress. One complication that can occur in infants and
young children is dehydration. These lesions in the mouth
can be so painful that a child may stop drinking. Push fluids
as much as possible, but if this fails, intravenous fluids
may be necessary.
ONE
DOCTOR'S OPINION:
This
is a very painful, but fortunately self-limited illness. It
will come and go in one to two weeks. If you can make it through
without getting dehydrated, then you have done well. Use topical
pain medications for the mouth, push fluids as much as possible,
and wait the one to two weeks for the illness to go away.
It is very contagious for other children so wash any saliva
off toys and any surfaces. Also immediately wash your hands
if you came in contact with any of the saliva. Otherwise you
can transmit this illness to others through contact with your
hands.
