Hand-Foot-and-Mouth Disease Workup

Updated: Aug 15, 2016
  • Author: Stephen J Nervi, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Workup

Laboratory Studies

The diagnosis of hand-foot-and-mouth disease (HFMD) is typically based on clinical grounds. Laboratory studies are usually unnecessary.

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 also a good source for viral collection. In patients without vesicles, rectal swabs can be collected. For viral isolation, 2 swab collections are recommended—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. [3]