Dermatologic Manifestations of Enteroviral Infections Treatment & Management

Updated: Jul 12, 2016
  • Author: Mercè Alsina-Gibert, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Enteroviral infections in immunocompetent individuals heal spontaneously within 7-10 days; therefore, the main goal of treatment is symptomatic relief.

Neonates show a wide spectrum of signs and symptoms, which range from a nonspecific febrile illness to potentially fatal multisystem disease. [2]

Fever

Adequate hydration and antipyretics, such as acetaminophen, are helpful.

Immunoglobulin

Some anecdotal evidence suggests that prophylactic immunoglobulin can mitigate disease severity in some exposed neonates. Immunoglobulin has also been used for the treatment of symptomatic infants with enterovirus infection. [2]

Pleconaril

This is another antiviral drug that has demonstrated efficacy against enteroviruses. It is a broad-spectrum antiviral drug that blocks enteroviral attachment to cellular receptors. [38, 39, 40] Pleconaril therapy is prescribed for the treatment of severe neonatal enteroviral sepsis. [41]

Pyridyl imidazolidinone

A novel class of capsid binder, pyridyl imidazolidinone can inhibit enterovirus 71. [1]

Vaccination

Development of an inactivated enterovirus vaccine [42] and an inactivated whole-virus–based bivalent vaccine for both enterovirus 71 and coxsackie A virus 16 is in progress. [43]

Oral lesions

Mouth rinses with topical anesthetics (eg, lidocaine 2%) or antihistamines (eg, diphenhydramine hydrochloride) may relieve oral pain. [44]

Acyclovir was used in an open clinical trial involving 13 patients with hand-foot-and-mouth disease (HFMD). Involution of oral lesions occurred within 24 hours of the start of therapy. The mechanism of action was unknown; to the authors’ knowledge, no other series results have been published.

Allopurinol mouthwashes (3 mg/mL) are reported to accelerate the resolution of oral lesions. [45]