Fever Duration in Hand, Foot, and Mouth Disease
Fever in hand, foot, and mouth disease typically lasts 3 days (median duration), with a range of 2 to 7 days, and is usually the first symptom to appear. 1
Fever Characteristics
Fever is typically low-grade but can exceed 102.2°F (39°C), often accompanied by malaise, general discomfort, sore throat, and irritability in young children 2
The fever usually precedes the characteristic rash and oral lesions, making it the initial presenting symptom in most cases 2
Most patients present to medical care around day 3 of illness (median), which often coincides with peak symptoms 1
Complete Disease Timeline
The entire illness typically resolves within 7 to 10 days, with lesions healing spontaneously without complications in most cases 3
Symptoms usually last less than 1 week in uncomplicated cases 4
Important Clinical Context
This fever pattern is distinctly different from Kawasaki disease, which is a critical differential diagnosis to exclude:
Kawasaki disease presents with high spiking fevers (>39-40°C) that persist for 1 to 3 weeks without treatment, or a mean of 11 days untreated 5
HFMD does not typically present with the high, persistent fever seen in Kawasaki disease 2
Unlike Kawasaki disease, HFMD presents with vesicular lesions rather than diffuse erythema 2
Common Pitfalls
Do not dismiss HFMD in adults - while primarily a childhood illness affecting those under 5 years old (87% of cases), it can occur at any age 1, 6
Poor feeding and dehydration are the primary reasons for hospital admission (76.7% of admissions), not the fever itself, as oral ulcers make eating and drinking painful 1