What is the treatment for an adult diagnosed with hand, foot, and mouth disease?

Treatment of Adult Hand, Foot, and Mouth Disease

The treatment for adult hand, foot, and mouth disease is primarily supportive care focused on symptom management, including adequate hydration and pain relief with acetaminophen or ibuprofen. 1

Clinical Presentation and Diagnosis

• Hand, foot, and mouth disease (HFMD) is a viral illness caused by human enteroviruses and coxsackieviruses
• Clinical presentation includes:
  • Low-grade fever (typically 37.8°C)
  • Maculopapular or papulovesicular rash on hands and feet
  • Painful oral ulcerations/vesicles
  • General malaise
  • Possible itching and burning sensation in the oral cavity 1, 2
• Diagnosis is primarily clinical, especially with a history of contact with an infected individual 2

Treatment Approach

First-line Management

1. Supportive care:

   • Ensure adequate hydration to prevent dehydration, especially if oral ulcers make drinking painful
   • Recommend cold, soft foods and beverages that don't irritate mouth ulcers
   • Avoid spicy, salty, or acidic foods that may exacerbate pain 1

2. Pain management:

   • Acetaminophen or ibuprofen for fever and pain relief
   • Dosing should follow standard adult recommendations:
     • Acetaminophen: 500-1000 mg every 4-6 hours (maximum 4000 mg/day)
     • Ibuprofen: 400-600 mg every 6-8 hours with food (maximum 2400 mg/day) 1

3. Oral care:

   • Warm saline mouthwashes (½ teaspoon salt in 8 oz warm water)
   • Oral hygiene with mild toothpaste and gentle cleaning 3
   • Note: Oral lidocaine is NOT recommended 1

Additional Considerations

• Most cases resolve spontaneously within 7-10 days without specific treatment 1, 4
• No specific antiviral treatment is currently available for HFMD 1, 5
• For hand lesions, topical moisturizers may provide symptomatic relief 3

Prevention of Transmission

• Handwashing with soap and water, especially after toilet visits and before handling food
• Disinfection of potentially contaminated surfaces and fomites
• Avoiding close contact (kissing, hugging, sharing utensils) with infected individuals
• Adults should stay home from work until fever resolves and mouth sores heal 1, 2

When to Seek Medical Attention

• Persistent high fever (>39°C)
• Signs of dehydration (decreased urination, dry mouth)
• Severe headache, neck stiffness, or altered mental status
• Difficulty breathing or rapid breathing
• These may indicate rare but serious neurological or cardiopulmonary complications 6, 5

Important Considerations

• While HFMD is typically considered a childhood disease, adults can also be affected, though less commonly
• Adult cases may present with more severe symptoms and longer recovery time
• Immunocompromised adults may experience more severe disease and complications
• The disease is highly contagious and transmitted through fecal-oral, oral-oral, and respiratory droplet contact 1, 2

HFMD is generally a self-limited condition in adults with excellent prognosis. Most patients recover completely within 7-10 days with appropriate supportive care and symptom management.