Hand-foot-and-mouth disease natural history
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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
Natural History, Complications and Prognosis
Natural History
Hand foot mouth disease begins with a mild fever, poor appetite, malaise ("feeling sick"), and sore throat. One to two days after the fever, painful sores develop in the mouth as small red spots that blister and become ulcers, they are usually seen on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days a flat red patch with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. 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. Most of the transmission occurs in the first week of illness. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months. Hand foot mouth disease usually resolves in a week to 10 days, but very rarely complications such as meningitis can occur.
Complications
Complications of hand-foot and mouth disease include:
- Viral or aseptic meningitis, it presents with fever, headache, stiff neck, or back pain.
- Encephalitis
- A polio-like paralysis
- Fingernail and toenail loss, usually occurs mostly in children within 4 weeks of having hand, foot, and mouth disease. However, the nail loss has been temporary and nail growth resumed without medical treatment.[1]
- Acute flaccid paralysis)
- Cardiopulmonary failure
- Pulmonary edema or pulmonary hemorrhage.
Prognosis
Hand foot mouth disease is a self limiting disease and complete recovery occurs in 5 to 7 days.