Abstract：
BACKGROUND: Hand, foot, and mouth disease is a common viral disease in childhood. Because the disease has the potential to reach epidemic levels and mortality is high in some countries, early recognition of this disease is of paramount importance.
OBJECTIVE: This purpose of this article is to familiarize pediatricians with the clinical manifestations and management of hand, foot, and mouth disease.
METHODS: A search was conducted in February 2022 in PubMed Clinical Queries using the key term \"hand, foot, and mouth disease\". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in English were included in this review.
RESULTS: Hand, foot, and mouth disease is characterized by a painful oral enanthem and asymptomatic exanthem on the palms and soles. Children younger than 5 years are most commonly affected. Hand, foot, and mouth disease caused by enterovirus A71 is more severe and has a higher rate of complications than that attributed to other viruses such as coxsackievirus A16. Circulatory failure secondary to myocardial impairment and neurogenic pulmonary edema secondary to brainstem damage are the main causes of death. Fortunately, the disease is usually benign and resolves in 7 to10 days without sequelae. Given the self-limited nature of most cases, treatment is mainly symptomatic and supportive. Intravenous immunoglobulin should be considered for the treatment of severe/complicated hand, foot, and mouth disease and has been recommended by several national and international guideline committees. Currently, there are no specific antiviral agents approved for the treatment of the disease. Drugs such as ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline have emerged as potential candidates for the treatment of hand, foot, and mouth disease. Vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures to combat the disease.
CONCLUSIONS: Familiarity of the disease including its atypical manifestations is crucial so that a correct diagnosis can be made, and appropriate treatment initiated. A timely diagnosis can help avoid contact with the affected individual and decrease the risk of an outbreak.
OBJECTIVE: This purpose of this article is to familiarize pediatricians with the clinical manifestations and management of hand, foot, and mouth disease.
METHODS: A search was conducted in February 2022 in PubMed Clinical Queries using the key term \"hand, foot, and mouth disease\". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in English were included in this review.
RESULTS: Hand, foot, and mouth disease is characterized by a painful oral enanthem and asymptomatic exanthem on the palms and soles. Children younger than 5 years are most commonly affected. Hand, foot, and mouth disease caused by enterovirus A71 is more severe and has a higher rate of complications than that attributed to other viruses such as coxsackievirus A16. Circulatory failure secondary to myocardial impairment and neurogenic pulmonary edema secondary to brainstem damage are the main causes of death. Fortunately, the disease is usually benign and resolves in 7 to10 days without sequelae. Given the self-limited nature of most cases, treatment is mainly symptomatic and supportive. Intravenous immunoglobulin should be considered for the treatment of severe/complicated hand, foot, and mouth disease and has been recommended by several national and international guideline committees. Currently, there are no specific antiviral agents approved for the treatment of the disease. Drugs such as ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline have emerged as potential candidates for the treatment of hand, foot, and mouth disease. Vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures to combat the disease.
CONCLUSIONS: Familiarity of the disease including its atypical manifestations is crucial so that a correct diagnosis can be made, and appropriate treatment initiated. A timely diagnosis can help avoid contact with the affected individual and decrease the risk of an outbreak.
摘要：
背景：手，脚,口蹄疫是儿童时期常见的病毒性疾病。因为这种疾病有可能达到流行水平，而且在一些国家死亡率很高，早期识别这种疾病至关重要。
目的：本文的目的是使儿科医生熟悉手的临床表现和管理，脚,和口病。
方法：于2022年2月在PubMed临床查询中使用关键术语“手，脚,和口蹄疫”。搜索策略包括所有临床试验，观察性研究，以及在过去十年内发表的评论。本评论仅包括以英语发表的论文。
结果：手，脚,口蹄疫的特征是口腔疼痛和手心和脚底无症状的发作。5岁以下的儿童最常见。手,脚,由肠道病毒A71引起的口病比其他病毒如柯萨奇病毒A16引起的更严重，并发症发生率更高。继发于心肌损害的循环衰竭和继发于脑干损害的神经源性肺水肿是死亡的主要原因。幸运的是,这种疾病通常是良性的，在7到10天内消退，没有后遗症。鉴于大多数情况下的自我限制性质，治疗主要是对症和支持。静脉免疫球蛋白应考虑用于治疗严重/复杂的手，脚,和口蹄疫，并已被几个国家和国际准则委员会推荐。目前,目前尚无特定的抗病毒药物被批准用于治疗该疾病。药物如利巴韦林,苏拉明,MulberrosideC,氨基噻唑类似物，舍曲林已经成为治疗手部的潜在候选者，脚,和口病。在高风险地区为易感个体接种疫苗和良好的个人卫生是对抗该疾病的重要预防措施。
结论：熟悉该疾病，包括其非典型表现至关重要，以便做出正确的诊断，并开始适当的治疗。及时诊断有助于避免与受影响的个体接触，并降低爆发的风险。
目的：本文的目的是使儿科医生熟悉手的临床表现和管理，脚,和口病。
方法：于2022年2月在PubMed临床查询中使用关键术语“手，脚,和口蹄疫”。搜索策略包括所有临床试验，观察性研究，以及在过去十年内发表的评论。本评论仅包括以英语发表的论文。
结果：手，脚,口蹄疫的特征是口腔疼痛和手心和脚底无症状的发作。5岁以下的儿童最常见。手,脚,由肠道病毒A71引起的口病比其他病毒如柯萨奇病毒A16引起的更严重，并发症发生率更高。继发于心肌损害的循环衰竭和继发于脑干损害的神经源性肺水肿是死亡的主要原因。幸运的是,这种疾病通常是良性的，在7到10天内消退，没有后遗症。鉴于大多数情况下的自我限制性质，治疗主要是对症和支持。静脉免疫球蛋白应考虑用于治疗严重/复杂的手，脚,和口蹄疫，并已被几个国家和国际准则委员会推荐。目前,目前尚无特定的抗病毒药物被批准用于治疗该疾病。药物如利巴韦林,苏拉明,MulberrosideC,氨基噻唑类似物，舍曲林已经成为治疗手部的潜在候选者，脚,和口病。在高风险地区为易感个体接种疫苗和良好的个人卫生是对抗该疾病的重要预防措施。
结论：熟悉该疾病，包括其非典型表现至关重要，以便做出正确的诊断，并开始适当的治疗。及时诊断有助于避免与受影响的个体接触，并降低爆发的风险。
