Common viral illness primarily affecting children below 5 yr.

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Aetiology

Causative organisms:

Viruses of genus Enterovirus belonging to family Picornaviridae

• Coxsackievirus A16
• Enterovirus 71
• Less common: Polio virus, ECHO virus

• Transmission: Direct contact or infected fomites

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Clinical features

Prodrome

• Low-grade fever
• Feeling of being unwell
• Sore throat

Disease

• Ulcers or blisters in the oral cavity
  • Mostly on the posterior aspect
• Papulovesicular skin rash
  • Palms and soles and less commonly, on buttocks, knees, elbows and genital area
• Illness resolves quickly over 4-5 days

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Complications

• Temporary loss of toe/fingernails
  • 4 weeks after onset of disease
• Rare:
  • Aseptic meningitis
  • Encephalitis
  • Polio-like paralysis
  • Myocarditis
  • Respiratory distress syndrome

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Diagnosis

Diagnosis is clinical

Differential diagnosis:

Other illnesses causing oral ulcers:

• Herpangina
• Herpetic gingivostomatitis
• Aphthous ulcers
• Chickenpox

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Management

Symptomatic treatment

• Analgesics
• Soft diet

Prevention:

No vaccine is available against this disease

• Isolation of affected children at home
• Hand hygiene