Hand, foot and mouth disease

Hand, foot and mouth disease

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Hand, foot and mouth disease is an acute viral infection that presents as a vesicular eruption of the skin of the mouth. May also involve the hands, thighs and / or genitalia. Coxsackie virus type 16 is the etiologic agent involved in most cases, but the disease is associated with virus type A5, A7, A9, A10, B5. Enterovirus 71 has caused outbreaks of the disease associated with neurological involvement. Coxsackie virus and enterovirus subgroup is a member of the family Picornaviridae. This virus family consists of small, non-enveloped single-stranded RNA. Infection occurs by fecal-oral route or through contact with oral secretions and skin lesions. Develop viraemia followed by invasion of skin and mucous membranes.
The clinical picture includes macular lesions of oral mucosa, tongue and / or hard palate. It progresses rapidly to vesicles which erode and become surrounded by erythematous halos. Develop skin lesions in 75% of patients. Disease caused by enterovirus-71 EV neurological cause damage. Interfere with oral ulcers and cause dehydration fluids, most commonly found complication of the disease.
Treatment Miina-foot-mouth disease is supportive. Ensure adequate intake of fluids to prevent dehydration. Intravenous hydration may be necessary if the patient has moderate to severe dehydration and discomfort prevent oral intake. Fever is treated with antipyretics. Pain is treated with standard dose of acetaminophen or ibuprofen.
The disease is usually self-limiting, which can be solved in 7-10 days, rarely can persist or reappear. Serious complications are rare. Oral ulcers can cause severe painful stomatitis. This may interfere with oral intake and cause dehydration, the most common complication of the disease. Aseptic meningitis rarely accompanies Miina-foot-mouth disease. Disease caused by EV-71 type has a high incidence of neurological damage, including a poliolike syndrome, aseptic meningitis, encephalitis, encephalomyelitis, acute cerebral ataxia, acute transverse myelitis, Guillain-Barre syndrome and benign intracranial hypertension opsomioclonus. These neurological complications have been attributed imunopatologiei or destruction caused by the virus of gray matter.
Pathogenesis and causes
Miina-foot-mouth disease is caused by a group of RNA viruses called enteroviruses. The most commonly involved is the Coxsackie virus A16. However the disease can be caused by viruses and Coxsackie A5, A9, A10, B1, B3, and enterovirus 71 human HEV, and herpes simplex virus. It spreads by fecal-oral or oral-oral. Transmission by respiratory droplets may be a way but it is unlikely. Typically the virus multiplies in the gastrointestinal tract enters through the oral route. In the next 72 hours incubation period is determined by viremia and infection of the lymph node spread.
Coxsackie virus is very contagious. During the epidemic is spreading horizontal transmission from child to child and from mother to fetus. Transmission occurs through direct contact with nasal or oral secretions, feces or droplets adhering oral-oral or fecal-oral. Implantation is followed by initial oral viral spread to the lymph nodes in 24 hours. Viraemia soon spreading to the skin and oral mucosa. On 7 increases levels of neutralizing antibodies and the virus is eliminated.