Child health
AKT · Child health/Infection & rash
Hand, foot and mouth disease
Coxsackievirus A16 / enterovirus 71
Overview
A common, mild enteroviral illness of young children: oral ulcers/vesicles plus vesicles on the hands and feet. Self-limiting and unrelated to the animal foot-and-mouth disease.
Recognise
- Low-grade fever, sore throat, reduced feeding
- Painful oral ulcers/vesicles
- Vesicles on palms and soles (sometimes buttocks)
Red flags
- Dehydration from poor oral intake; rare neurological disease with enterovirus 71
Differentials & how to tell them apart
Herpetic gingivostomatitis (HSV)more severe oral ulceration + gingival inflammation, NO palm/sole vesicles
Chickenpox (varicella)widespread vesicles at different stages, not confined to hands/feet/mouth
Herpanginaposterior oral vesicles only (also coxsackie)
Investigations
Clinical; no tests usually needed.
Management
Supportive — analgesia and hydration
- 1Supportive: pain relief, encourage fluids; school exclusion not required.Gate: Poor oral intake → watch for dehydration, especially in the young child
- 2Reassure: self-limiting over ~7–10 days.
Supportive (analgesia, fluids) — no antiviral; ensure hydration
Key points
Distinguish from HSV gingivostomatitis (no acral vesicles) and chickenpox (generalised, cropping). The hand+foot+mouth distribution is the giveaway.
Monitor & prognosis
Hydration; resolution.
Excellent, self-limiting.
Source: NICE CKS Hand, foot and mouth disease