Symptoms of Hand, Foot, and Mouth Disease
Hand, foot, and mouth disease (HFMD) typically presents with low-grade fever, painful oral ulcerations, and a characteristic maculopapular or papulovesicular rash on the hands and soles of the feet.
Primary Clinical Manifestations
Fever:
- Low-grade fever (typically <102°F/39°C)
- Usually occurs at disease onset
- Lasts for 1-3 days
Oral Lesions:
- Painful oral ulcerations/sores
- Commonly affects tongue, gums, inside of cheeks
- May present as erythema, cracking of lips
- Can cause sore throat and decreased oral intake
- Often described as "strawberry tongue" appearance
Skin Rash:
- Maculopapular or papulovesicular eruptions
- Characteristic distribution on:
- Palms of hands
- Soles of feet
- Sometimes buttocks and genital area
- Non-itchy but may be painful
- Lesions typically 2-8mm in diameter
Timeline and Additional Features
- Symptoms typically develop 3-7 days after exposure (incubation period)
- Oral lesions often appear first, followed by the skin rash
- Lesions usually resolve within 7-10 days without scarring 1
- May be accompanied by:
- Malaise
- Irritability
- Decreased appetite
- Myalgia (muscle pain)
Complications
While HFMD is typically self-limiting, rare complications may occur:
- Nail changes (Beau's lines or nail shedding) weeks after initial infection 2
- Neurological complications (rare):
- Aseptic meningitis
- Encephalitis
- Cardiopulmonary complications (very rare) 3
Special Considerations
- Adults may experience more severe symptoms than children 4, 5
- Atypical presentations may occur with certain strains:
- More widespread rash
- More severe symptoms with Coxsackievirus A6
- Immunocompromised individuals may experience more severe disease
Transmission
HFMD spreads through:
- Fecal-oral contact
- Oral-oral contact
- Respiratory droplets
- Contact with contaminated surfaces and objects
Prevention
- Regular handwashing, especially after diaper changes and before eating
- Disinfection of potentially contaminated surfaces
- Avoiding close contact with infected individuals
- Children should stay home from school/daycare until fever resolves and mouth sores heal
HFMD is most common in children under 5 years of age but can affect individuals of any age. The diagnosis is typically clinical based on the characteristic distribution of lesions.