Materiały źródłowe

• #1 Hand, foot, and mouth disease and herpangina – UpToDate

  https://www.uptodate.com/contents/hand-foot-and-mouth-disease-and-herpangina

  Hand, foot, and mouth disease (HFMD) is a clinical syndrome characterized by an oral enanthem and a macular, maculopapular, or vesicular rash of the hands and feet (and possibly other locations). […] HFMD is one of the most recognizable viral exanthems in children and adults. […] An overview of HFMD and herpangina will be presented here. […] Multiple enterovirus serotypes cause HFMD and herpangina. […] Coxsackievirus A16 and enterovirus A71 (EV-A71) are the serotypes most frequently associated with HFMD and are responsible for the majority of large outbreaks. […] Beginning in 2008, coxsackievirus A6 has been increasingly reported as a cause of outbreaks of HFMD around the world.

• #2 Hand, Foot, and Mouth Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK431082/

  Hand, foot, and mouth disease (HFMD) is a common viral illness that usually affects infants and children but can also affect adults. […] The diagnosis of HFMD is usually made clinically. The virus can be detected in the stool about 6 weeks after infection; however, shedding from the oropharynx is generally less than 4 weeks. Light microscopy of biopsies or scrapings of vesicles differentiates HFMD from varicella-zoster virus and herpes simplex virus. […] Today, polymerase chain reaction assays are available in most centers to confirm the diagnosis of coxsackievirus. A swab of the lesion can detect coxsackievirus or enterovirus using real-time PCR assays.

• #3 Hand-Foot-and-Mouth Disease (HFMD) Workup: Laboratory Studies

  https://emedicine.medscape.com/article/218402-workup

  The diagnosis of hand-foot-and-mouth disease (HFMD) is typically based on clinical grounds. Laboratory studies usually are unnecessary. However, when it mimics Stevens-Johnson Syndrome or erythema multiforme, a skin biopsy specimen would be desirable. […] The virus can be isolated and identified via culture and immunoassay from cutaneous lesions, mucosal lesions, or stool samples. Oral specimens have the highest isolation rate. In patients with vesicles, vesicle swabs also are a good source for viral collection. In patients without vesicles, rectal swabs can be collected. For viral isolation, two swab collections are recommended one from the throat and the other from either vesicles or the rectum. […] Serologic testing (eg, acute and convalescent antibody levels) may be obtained. […] Differentiating coxsackie-associated from EV-71 associated HFMD may have prognostic significance. Polymerase chain reaction (PCR) and microarray technology are among the various ways of identifying the causative virus. Specific assays vary between hospitals.

• #4 Hand-Foot-and-Mouth Disease: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1001/p408.html

  Hand-foot-and-mouth disease is a clinical diagnosis based on the presentation of a low-grade fever with a maculopapular or papulovesicular rash on the hands and soles of the feet and by painful oral ulcerations. […] If the diagnosis is unclear, serologic and polymerase chain reaction studies may be obtained to detect enterovirus or coxsackievirus. […] The diagnosis of hand-foot-and-mouth disease should be based on presentation of a maculopapular or papulovesicular rash on the hands and soles of the feet and painful oral ulcerations. […] The best methods to prevent the spread of hand-foot-and-mouth disease are handwashing and disinfecting potentially contaminated surfaces and fomites. […] Management is supportive and directed toward the relief of pain, lowering of fever, and adequate oral hydration because of the self-limiting nature of hand-foot-and-mouth disease.

• #5

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ty6230

  A doctor can tell if your child has hand-foot-and-mouth disease by the symptoms you describe and by looking at the sores and blisters. Tests usually aren’t needed. […] Hand-foot-and-mouth disease usually doesn’t need treatment. You can use home care to help relieve your child’s symptoms.

• #6 Hand-foot-and-mouth disease – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/685

  Hand-foot-and-mouth disease is a highly contagious childhood viral infection. […] Diagnosis is usually clinical, based on a typical history and characteristic clinical features. […] Key diagnostic factors include low-grade fever, oral vesicles and ulcers, and rash and/or vesicles on the hands and feet. […] Other diagnostic factors may include malaise, sore mouth, loss of appetite, sore throat, rash and/or vesicles on the buttocks, abdominal pain, diarrhea, cough, tongue erythema/edema, and arthralgia. […] Tests to consider for diagnosis include viral culture and CBC. […] Emerging tests include PCR molecular assays.

• #7 Hand-foot-and-mouth disease – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/685?locale=ko

  Hand-foot-and-mouth disease is a highly contagious childhood viral infection. […] Diagnosis is usually clinical, based on a typical history and characteristic clinical features. […] Key diagnostic factors include low-grade fever, oral vesicles and ulcers, and rash and/or vesicles on the hands and feet. […] Other diagnostic factors include malaise, sore mouth, loss of appetite, sore throat, rash and/or vesicles on the buttocks, abdominal pain, diarrhea, cough, tongue erythema/edema, and arthralgia. […] Tests to consider for diagnosis include viral culture and CBC. […] Emerging tests include PCR molecular assays.

• #8 Hand, Foot, and Mouth disease (HFMD): Enteroviral vesicular stomatitis – DermNet

  https://dermnetnz.org/topics/hand-foot-and-mouth-disease

  HFMD is usually diagnosed clinically. Cutaneous lesions are typically distributed symmetrically over common sites of the skin such as the hands, feet, and in and around the mouth in a child. […] Other diagnostic tools include: Polymerase chain reaction (PCR) testing. Viral DNA may be detected from nasopharyngeal, (throat or nose), swabs and stool specimens. Analysis of blood, cerebrospinal fluid (CSF), and faeces samples can confirm the diagnosis, but are rarely needed except in atypical or severe cases. […] Skin biopsy of a blister is very rarely indicated. Shows acral skin with lymphocytic infiltrates at the epidermis. The infiltrate is associated with keratinocyte apoptosis in early lesions.

• #9 Hand-Foot-and-Mouth Disease (HFMD): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/218402-overview

  Hand-foot-and-mouth disease (HFMD) is an acute viral illness that presents as a vesicular eruption in the mouth, but it also can involve the hands, feet, buttocks, and/or genitalia. […] The diagnosis of HFMD is typically based on clinical grounds. Laboratory studies usually are unnecessary, but the following may be done: […] The virus can be isolated and identified via culture and immunoassay from cutaneous lesions, mucosal lesions, or stool samples; oral specimens have the highest isolation rate. […] In patients with vesicles, vesicle swabs are a good source for viral collection. […] For viral isolation, two swab collections are recommended: From the throat and from either vesicles or the rectum. […] Serologic testing (eg, acute and convalescent antibody levels) may be obtained. […] Differentiating coxsackievirus-associated HFMD from EV-71 associated HFMD may have prognostic significance. […] PCR and microarray technology are among the various ways of identifying the causative virus.

• #10 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-hand-foot-and-mouth-disease.aspx

  Hand foot and mouth disease is a viral illness commonly affecting children below 10 years of age. […] Diagnosis is usually clinical. […] Diagnosis is suspected based on characteristic features of the patient that distinguish HFMD from other viral infections. This includes age of the patient (usually below 10 years) and pattern of the symptoms. […] Clinical diagnosis is confirmed by sending a throat or stool sample to the laboratory. The result usually takes a few days. In the laboratory the strain of enterovirus causing the infection is determined and confirmed. […] Laboratory diagnosis involves: The samples from throat, fluids from blisters and stools are cultured in the laboratory and once their numbers are raised by incubating them in culture media in the lab they are examined under the microscope.

• #11 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-hand-foot-and-mouth-disease.aspx

  Blood and serum samples as well as Cerebrospinal fluid may be sent for detection of the virus. The CSF samples are important in complicated cases with viral or aseptic meningitis. […] Reverse transcription by polymerase chain reaction (RT-PCR) is used to detect the virus in the samples. This detects the viral genes or DNA and RNA in the samples.

• #12 SANSURE – INNOVATING DIAGNOSTICS FOR ALL

  https://www.sansureglobal.com/hand-foot-and-mouth-disease-in-children-symptoms-causes-diagnosis/

  Molecular testing refers to using reverse transcription polymerase chain reaction (RT-PCR) to detect the viruss genetic material. Molecular tests can help plan treatment, determine whether a treatment is working, and predict a patients outlook. Additionally, the rapid development of molecular biology provides a reliable technical means for detecting pathogens. […] Diagnosis of HFMD is usually made using clinical diagnostic methods. Furthermore, RT-PCR can also be used for laboratory testing. For example, nasopharyngeal swabs can be used to detect airway secretions, positive results for virus-specific nucleic acids such as CoxA16 and EV71 in herpes fluid or feces, or the isolation of enteroviruses to diagnose the disease. […] Using RT-PCR as a method of diagnosing HFMD offers several potential advantages. The main advantage is that the detection sensitivity is improved, and the RT-PCR is easy to operate and avoids cross-contamination. Another important advantage is that RT-PCR can quickly and accurately distinguish CoxA16 and EV17, so patients can prevent HFMD as early as possible and reduce the occurrence of severe diseases.

• #13 Hand, Foot, and Mouth Disease (HFMD) – National Collaborating Centre for Infectious Diseases

  https://nccid.ca/debrief/hand-foot-and-mouth-disease/

  HFMD is primarily diagnosed clinically. However, a few laboratory tests are available if the diagnosis is uncertain or when severe disease is suspected. […] Confirmed diagnosis is based on cell culture, virus isolation and identification of enteroviruses. […] Polymerase chain reaction (PCR) assays are available to confirm presence of coxsackievirus and enterovirus. […] The specimens examined are usually scrapings or biopsies of the vesicle, upper respiratory tract or faecal specimens or from specimens of cerebrospinal fluid in case of suspected meningitis.

• #14 Foot-and-Mouth Disease (FMD) | Iowa State University

  https://vetmed.iastate.edu/vdpam/about/focus-areas/swine/swine-disease-manual/index-diseases/foot-mouth-disease

  Diagnosis cannot be made reliably on the basis of clinical signs and lesions since they are similar in all the vesicular viral diseases of swine. […] The state veterinary office should be contacted immediately if an outbreak is suspected. Differential diagnosis of vesicular viral diseases should only be completed in specifically-designated laboratories having specific arrangement to safely handle exotic disease organisms. Plans must be made for collecting and mailing specimens. […] Diagnostic techniques used include serologic tests to identify FMD virus infection-associated antigen (VIA), complement fixation (CF) and enzyme-linked immunosorbent assay (ELISA) tests to detect FMD viral antigen, virus isolation (VI) and neutralization (VN), electron microscope (EM), and animal inoculation studies. Polymerase chain reaction (PCR) tests have been developed and are frequently utilized. FMD must be differentiated from all other vesicular viral diseases and from other diseases that cause erosive/ulcerative lesions in the oral cavity. Positive diagnoses usually require less time than negative diagnoses. An ELISA is available that can differentiate antibody titers from infected versus vaccinated animals but is not yet officially recognized by many countries.

• #15 Hand, foot and mouth disease pathology

  https://dermnetnz.org/topics/hand-foot-and-mouth-disease-pathology

  Hand, foot and mouth disease is a viral illness caused by coxsackievirus A16 and enterovirus 71. […] PCR studies can be performed on tissue blocks for identification of coxsackievirus A16 and enterovirus 71.

• #16 Hand Foot and Mouth Disease | Diagnosis | HFMD | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/hand-foot-mouth/about/diagnosis.html

  Hand, foot, and mouth disease is one of many infections that causes mouth sores. Health care providers can usually identify mouth sores caused by hand, foot, and mouth disease by considering […] Depending on how severe the symptoms are, samples from the throat or feces (stool) may be collected and sent to a laboratory to test for the virus.

• #17 Hand-foot-and-mouth disease differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Hand-foot-and-mouth_disease_differential_diagnosis

  Hand-foot-and-mouth disease should be differentiated from other conditions that cause maculopapular or vesicular rash which includes herpes simplex virus infections, herpangina, chicken pox and measles. […] Hand-foot-and-mouth disease should be differentiated from other conditions that cause maculopapular or vesicular rash include: […] The following table is a list of differential diagnosis and their features: […] History and Physical exam […] Throat swabs […] Swabs from the lesion […] Tzanck test […] Clinical diagnosis […] Pharyngeal viral and bacterial cultures can be taken to exclude HSV infection and streptococcal pharyngitis. […] Tzanck test demonstrates multinucleated epithelial giant cells […] Viral culture is the gold standard for diagnosis […] Direct immunofluorescence.

• #18 Hand, Foot, and Mouth Disease (HFMD): A Comprehensive Guide

  https://www.webmd.com/children/hand-foot-mouth-disease

  Your doctor will ask about your or your childs symptoms and look at any sores or rashes. This is usually enough for them to decide if its hand, foot, and mouth disease. But they might also swab your childs throat or take a sample of poop or blood for lab testing. […] Theres no cure or vaccine for hand, foot, and mouth disease. Because a virus causes it, antibiotics wont help. It usually goes away on its own after 7-10 days. In the meantime, you can ease symptoms with: […] While there is no specific medical treatment for HFMD, most people get better on their own in 7-10 days. […] Serious complications from hand, foot, and mouth disease are rare. Enterovirus 71 is more likely to cause problems than other HFMD viruses. […] HFMD can be mistaken for other viruses and illnesses, including chickenpox, mpox (monkeypox), and even insect bites or herpes.

• #19 A clinical scoring system for pediatric hand-foot-mouth disease | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06424-w

  The aim of the present study was to develop a clinical scoring system for the diagnosis of hand-foot-mouth disease (HFMD) with improved accuracy. […] Using the logistic model, we identified seven clinical variables (age, exposure history, and rash density at specific regions of the body) to be included into the scoring system. […] This study establishes an objective scoring system for the diagnosis of typical and atypical HFMD using measures accessible through routine clinical encounters. […] The gold standard in the diagnosis of HFMD is the Polymerase Chain Reaction (PCR)-based viral nucleic acid sequence detection assay. […] In this study, we analyzed clinical data collected from patients suffering from acute rash illness with confirmatory viral assays to establish an objective, accessible, and sensitive diagnostic scoring system for the rapid identification of HFMD in children under three years of age. […] Our study identified seven clinical variables with significant impacts on the accuracy of HFMD diagnosis.

• #20

  https://link.springer.com/article/10.1007/s12519-018-0189-8

  Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed. […] Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. […] The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. […] The guidelines can provide systematic guidance on the diagnosis and management of HFMD.

• #21 Laboratory Indicators for Identifying Hand, Foot, and Mouth Disease Severity: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2076-393X/10/11/1829

  Hand, foot, and mouth disease (HFMD) is a common pediatric disease caused by a variety of human enteroviruses (EVs). HFMD usually affects preschool children (age < 5 years) and has experienced widespread prevalence in this population in recent years. The main clinical features of HFMD are fever, mouth ulcers, and skin rashes on the hands, feet, and buttocks, and it is usually transmitted through feces, respiratory droplets, contact with blister fluid, or close contact with infected children. HFMD is a mild, self-limiting disease, but a number of patients develop severe disease, with central nervous systems (CNS) complications. These CNS complications are brainstem encephalitis, acute flaccid paralysis, neurogenic pulmonary edema, cerebellar ataxia, and aseptic meningitis. The complications and sequelae caused by severe HFMD are very serious, which become a heavy burden on families, communities, and societies. At present, clinicians mainly use clinical manifestations to identify severe cases, which often leads to overdiagnosis. Therefore, it is valuable to seek a laboratory differential diagnostic protocol for severe cases, such as laboratory indicators, to identify HFMD severity at the early stages of the disease.

• #22 Laboratory Indicators for Identifying Hand, Foot, and Mouth Disease Severity: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2076-393X/10/11/1829

  The purpose of this meta-analysis is to investigate the possibility of clinical indicators as predictors of HFMD severity, which can provide a basis for predicting the prognosis and taking early and effective medical treatment. According to the Guidelines for Diagnosis and Treatment of HFMD (2018 edition) by the Ministry of Health of the People’s Republic of China, the disease degree of HFMD is classified as follows: (1) the main symptoms are fever, and a rash on the hands, feet, mouth and buttocks. This stage is a common type of HFMD; (2) the manifestations include poor mental health, drowsiness, weakness in sucking, easy startling, headache, vomiting, irritability, limb tremors, muscle weakness, and neck stiffness. Patients who have the above manifestations are severe cases; (3) pre-cardiopulmonary failure occurs within 5 days of disease onset and is characterized by an increased heart rate and respiration, cold sweats, chills at the ends of the extremities, skin flushing, and increased blood pressure. Patients who have the above manifestations are critical cases; (4) the clinical manifestations include tachycardia (individually bradycardia), shortness of breath, cyanosis of the lips and mouth, coughing up pink frothy sputum or bloody fluid, and reduced blood pressure or shock. Patients who have the above manifestations are also critical cases, with a high mortality rate. According to the Chinese guidelines for the diagnosis and treatment of HFMD (2018 edition), stage (1) is defined as mild; stages (2), (3), and (4) are defined as severe.

• #23 Laboratory Indicators for Identifying Hand, Foot, and Mouth Disease Severity: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2076-393X/10/11/1829

  Our study indicated that white blood cells (WBC), blood glucose, lymphocytes, creatinine, interleukin (IL)-2, IL-6, IL-8, IL-10, interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and creatine kinase MB isoenzyme (CK-MB) were associated with an increased risk of HFMD severity, and the results of the sensitivity analysis of these indicators were stable and free of publication bias. Our results suggest that various deleterious immune and metabolic changes can increase the risk of HFMD severity, which can provide a basis for predicting the prognosis and useful evidence for clinicians to manage patients efficiently.

• #24 Hand, Foot & Mouth Disease (HFMD): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/11129-hand-foot-and-mouth-disease

  Hand, foot and mouth disease (HFMD) is a very contagious viral infection that causes a blister-like rash on your child’s hands and feet and painful sores in their mouth. […] Hand, foot and mouth disease is typically mild and usually clears up on its own within seven to 10 days. […] A healthcare provider can diagnose hand, foot and mouth disease by looking at your child’s blisters. Occasionally, they’ll test for the virus by sending throat swab samples, or samples taken from blisters or stool (poop), to a lab. […] There’s no medication for hand, foot and mouth disease. Antibiotics won’t work because they don’t treat viruses. […] Symptoms of hand, foot and mouth disease tend to be mild and go away with minimal treatment in less than two weeks.

• #25 About Hand, Foot, and Mouth Disease | Hand, Foot, and Mouth Disease (HFMD) | CDC

  https://www.cdc.gov/hand-foot-mouth/about/index.html

  HFMD is very contagious and usually causes fever, mouth sores, and skin rash. It is common in children under 5 years old, but anyone can get it. […] HFMD is usually not serious. Most people get better on their own in 7 to 10 days with minimal or no medical treatment. […] Talk with your child’s healthcare provider if you are still not sure when it is okay for them to return. Sometimes, the local health department may require children with HFMD to stay home to control an outbreak.

• #26 Hand-Foot-and-Mouth Disease: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1001/p408.html

  Indications for hospitalization include a failure to maintain adequate hydration or the development of neurologic or cardiopulmonary complications. […] Antiviral treatments are not available. One clinical trial of acyclovir (n = 13) reported a reduction of fever and skin changes within 24 hours; however, more evidence is needed.

• #27 Hand, Foot and Mouth Disease : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/hand-foot-and-mouth-disease-2/

  Hand, foot and mouth disease (HFMD) is a common illness mostly affecting patients younger than 10 years, though adults can be affected as well. […] Diagnosis of Typical and Atypical Hand, Foot and Mouth Disease […] Clinical diagnosis based on typical clinical features: […] Diagnosis is generally made on history and physical exam. […] May consider RT-PCR for enteroviruses in CSF, serum, urine, NP or oropharyngeal swab which are highly specific and sensitive for acute infection. […] Other laboratory testing is not necessary for most cases of hand, foot and mouth disease, although they may be considered for investigating acute complications. […] Asses for complications of hand, foot and mouth disease and initiate investigations where there is clinical suspicion: […] Investigations: LP with viral panel, cell count, glucose, chemistry, culture. CSF parameters may be normal in up to 50% of young infants, despite detection of enterovirus. […] Evidence for diagnosis, treatment and avoidance of spread are based on expert consensus.

• #28 What doctors wish patients knew about hand, foot and mouth disease | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-hand-foot-and-mouth-disease

  Hand, foot and mouth disease is a common infection that causes sores in and around the mouth, said Dr. Yen, noting that the sores and rash are often in a characteristic pattern on the hands, feet and even the buttocks, hence the name hand, foot and mouth disease. […] Almost all cases of hand, foot and mouth disease are diagnosed visually or clinically, Dr. Yen said, noting you’re putting the clinical picture together, which means looking at the symptoms, looking for the characteristic rash and the pattern of the rash is often helpful in terms of where it’s occurring on the body. […] As for testing, there’s not usually a test done. If you get technical, there is specific viral testing you could do on body fluids to try to find a specific virus, but it’s almost never done because it’s not necessary and it doesn’t really add anything in terms of your diagnosis or treatment.

• #29 Hand, Foot, and Mouth Disease: Symptoms and Treatment

  https://www.healthline.com/health/hand-foot-mouth-disease

  How is hand, foot, and mouth disease diagnosed? A doctor can often diagnose HFMD by performing a physical exam. Theyll check your mouth and body for the appearance of blisters and rashes. The doctor will also ask you or your child about other symptoms. The doctor may take a throat swab or stool sample to test for the virus. This will allow them to confirm the diagnosis. […] People with HFMD are most likely to pass on the infection during the first week of the illness. They can sometimes still pass it on for a few weeks after symptoms go away, but this is less likely.

• #30 Hand, Foot, and Mouth Disease (HFMD): A Comprehensive Guide

  https://www.webmd.com/children/hand-foot-mouth-disease

  You are most contagious during the first week of illness, but people can still spread the virus to others for days or weeks after symptoms go away, or even if they have no symptoms at all. […] HFMD mostly affects infants and young children, but adults can catch the disease, especially if they have a weakened immune system. Adults also are more likely to show no symptoms of the disease at all, but can still be contagious.

• #31

  https://www.parkwayshenton.com.sg/conditions-diseases/hand-foot-mouth-disease/diagnosis-treatment

  Hand, foot and mouth disease (HFMD) is typically diagnosed through a clinical examination. […] You should bring your child to a doctor for clearance to return to childcare or school when their blisters have fully dried up and oral ulcers have healed.

• #32 Hand, Foot, and Mouth Disease

  https://www.healthhub.sg/a-z/diseases-and-conditions/hfmd

  Laboratory testing is available to isolate and identify the causative agent. However, testing is usually not necessary as diagnosis of HFMD is typically based on clinical grounds. […] If you suspect any of the above, DO NOT send your child to the centre. Take him/her to a family doctor for a thorough examination. If your child is diagnosed with HFMD, please keep him/her at home until fully recovered. Your child should return to the centre only after the expiry of the MC given by the family doctor when he/she is well.

• #33 Hand, foot and mouth disease as an important public health challenge: clinical manifestation, diagnosis and treatment, literature review | Cudzik-Dziurzyńska | Forum Medycyny Rodzinnej

  https://journals.viamedica.pl/forum_medycyny_rodzinnej/article/view/100565

  Hand, foot and mouth disease (HFMD) is an infectious viral ailment usually of mild nature, triggered by enteroviruses and the coxsackie virus. […] Today, the established diagnostic criteria for HFMD rely mainly on clinical symptoms and patient history. […] Understanding Boston exanthem disease and encompassing both typical and atypical symptoms is essential for accurate diagnosis and effective treatment protocols.

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