Treatment of Hand, Foot, and Mouth Disease (HFMD)
The treatment for Hand, Foot, and Mouth Disease is primarily supportive care, focusing on symptom management, as HFMD is typically a self-limiting viral illness that resolves within 7-10 days. 1, 2
Clinical Presentation
- HFMD is a highly contagious viral infection primarily caused by enteroviruses, most commonly Coxsackievirus A16, Coxsackievirus A6, and Enterovirus 71 1, 3
- Typical symptoms include low-grade fever, malaise, sore throat, followed by characteristic maculovesicular eruptions on hands, feet, and oral cavity 4, 2
- While HFMD predominantly affects children under 5 years of age, it can also occur in adults 5, 6
Supportive Care Treatment Approach
Pain and Fever Management
- Administer oral analgesics such as acetaminophen or NSAIDs to relieve pain and reduce fever 1
- Avoid aspirin in children due to risk of Reye syndrome 1
Oral Lesion Management
- Encourage cold, soft foods and beverages that don't require much chewing 1
- Avoid spicy, salty, acidic foods and beverages that may irritate mouth sores 1
- Use mild toothpaste and gentle oral hygiene techniques 1
- Consider topical oral anesthetics (e.g., viscous lidocaine) for severe oral pain, but use with caution in young children 1
Hydration
- Maintain adequate hydration despite painful oral lesions 1, 2
- Consider using straws for liquids to bypass oral lesions 1
- Monitor for signs of dehydration, especially in young children 1
Skin Care
- Apply moisturizing creams to affected areas on hands and feet 1
- Avoid friction and heat exposure to affected areas 1
- Monitor for and treat any secondary bacterial infections 1
Special Considerations
- Immunocompromised patients may experience more severe disease and should be monitored closely 1
- Most cases resolve without complications within 7-10 days 2, 6
- Rare neurological complications such as encephalitis, meningitis, or acute flaccid myelitis/paralysis can occur, particularly with EV-71 infections 1, 6
Prevention and Control
- Hand hygiene is the most important preventive measure, with thorough handwashing with soap and water being more effective than alcohol-based sanitizers 1
- Environmental cleaning, particularly of toys and objects that may be placed in children's mouths 1
- Children with HFMD should avoid close contact with others until fever resolves and mouth sores heal 1
- Standard precautions should be followed in healthcare settings 1
When to Seek Medical Attention
- Persistent high fever (>101°F or 38.3°C) for more than 3 days 1, 2
- Signs of dehydration (dry mouth, decreased urination, lethargy) 1
- Development of neurological symptoms (headache, stiff neck, irritability, altered consciousness) 1, 6
- Severe pain that interferes with eating or drinking 1
HFMD is generally a benign, self-limiting condition that requires only supportive care. Severe complications are rare but may occur, especially with certain viral strains like EV-71 1, 6.