HFMD & Herpangina

Hand, Foot, and Mouth Disease (HFMD): Typically caused by Coxsackievirus A16 or Enterovirus 71. Presents with a prodrome of low-grade fever followed by oral ulcers and a characteristic peripheral rash.

Classic Lesion Morphology:

• Oral: Small vesicles that rapidly ulcerate on the tongue and buccal mucosa.
• Cutaneous: Small, elliptical (football-shaped) grayish vesicles on an erythematous base.
• Distribution: Palms, soles, buttocks, and sometimes knees/elbows.

Herpangina

• The Clue: Painful vesicles and ulcers restricted to the posterior oropharynx (soft palate, tonsils, uvula).
• Vs HFMD: Herpangina lacks the skin rash on the hands and feet. The fever is often higher and the throat pain is more severe.

Aphthous Ulcers (Mouth Ulcers)

• The Clue: Solitary or few painful ulcers with a yellow-white necrotic center and a halo of redness.
• Vs HFMD: Usually no systemic symptoms (fever) and no associated skin rash. Usually found on non-keratinized mucosa (inner lips/cheeks).

🚨 Urgent Admission if:

• Neurological: Persistent high fever, lethargy, irritability, seizures, or ataxia (suggests rhombencephalitis).
• Circulatory: Cold sweats, pallor, or tachycardia out of proportion to fever (suggests myocarditis).
• Dehydration: Poor oral intake (refusing to swallow due to pain) and reduced urine output.

• Notify
• Hydration: Frequent small sips of cold fluids, ice cream, or yogurt to soothe throat pain.
• Isolation