eMedicine Specialties > Infectious Diseases > Skin and Soft-Tissue Infections

Hand-Foot-and-Mouth Disease: Follow-up

Author: Stephen J Nervi, MD, Staff Physician, Department of Dermatology, University of Medicine and Dentistry of New Jersey, New Jersey School of Medicine
Coauthor(s): Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School; Rajendra Kapila, MD, MBBS, Professor of Medicine, Department of Medicine, UMDNJ, New Jersey Medical School; Diane H Johnson, MD, Assistant Director, Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, Winthrop-University Hospital, State University of New York at Stony Brook School of Medicine
Contributor Information and Disclosures

Updated: Oct 22, 2009

Follow-up

Further Inpatient Care

  • Patients with CNS manifestations of hand-foot-and-mouth disease (HFMD; eg, encephalitis, aseptic meningitis) may require hospitalization.

Further Outpatient Care

  • Closely observe infants with HFMD for development of dehydration.
  • Clinical improvement is observed after approximately 3-5 days; cutaneous and mucosal lesions resolve in 7-10 days. The patient may continue to shed virus through the stool for weeks.

Complications

  • Rarely, aseptic meningitis and other neurological complications accompany HFMD. More commonly, oral ulcerations can interfere with fluid intake and cause dehydration, the most common complication of HFMD.
  • Rare case reports show spontaneous abortions associated with HFMD.

Prognosis

  • The prognosis of HFMD is excellent. The vast majority of patients with this infection are expected to recover fully.

Miscellaneous

Medicolegal Pitfalls

  • Failure to make the diagnosis
  • Failure to maintain adequate hydration
  • Failure to recognize rare but serious neurological complications
 


More on Hand-Foot-and-Mouth Disease

Overview: Hand-Foot-and-Mouth Disease
Differential Diagnoses & Workup: Hand-Foot-and-Mouth Disease
Treatment & Medication: Hand-Foot-and-Mouth Disease
Follow-up: Hand-Foot-and-Mouth Disease
References
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Further Reading

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Keywords

hand-foot-and-mouth disease, HFMD, coxsackievirus, exanthematous eruptions, enterovirus 71, EV-71, Picornaviridae, aseptic meningitis, encephalitis, encephalomyelitis, mucosal lesions, mucocutaneous lesions, coxsackievirus A type 16, CV A16

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Contributor Information and Disclosures

Author

Stephen J Nervi, MD, Staff Physician, Department of Dermatology, University of Medicine and Dentistry of New Jersey, New Jersey School of Medicine
Stephen J Nervi, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Rajendra Kapila, MD, MBBS, Professor of Medicine, Department of Medicine, UMDNJ, New Jersey Medical School
Rajendra Kapila, MD, MBBS is a member of the following medical societies: American College of Physicians, American Medical Association, Infectious Diseases Society of America, and Infectious Diseases Society of New Jersey
Disclosure: Nothing to disclose.

Diane H Johnson, MD, Assistant Director, Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, Winthrop-University Hospital, State University of New York at Stony Brook School of Medicine
Diane H Johnson, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Medical Women's Association, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Medical Editor

Gary L Gorby, MD, Program Director of Adult Infectious Diseases Fellowship, Associate Professor, Department of Internal Medicine, Division of Infectious Disease, St Joseph Medical Center, Creighton University School of Medicine
Gary L Gorby, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and New York Academy of Sciences
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Thomas M Kerkering, MD, Chief of Infectious Diseases, Virginia Tech, Carilion School of Medicine, Roanoke, Virginia
Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

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