The following symptoms and complaints may indicate hand-foot-and-mouth disease (HFMK):
Classic hand-foot-and-mouth disease
Main symptoms
- Prodromal phase (precursor phase of the disease): fever (less than 5% of cases: > 38 °C), low appetite and sore throat.
- 1-2 days after onset of fever: painful enanthema (rash around mucous membranes) in the oral mucosa:
- Within 1-2 days: non-itchy exanthema (rash):
- With flat or raised red spots, sometimes blistering.
- Localization: palms and soles; possibly also buttocks, genital area, knees or elbows (here possibly occurrence as itchy rash = atypical courses).
- After about 7-14 days, there is a scarless healing of the skin lesions.
Note: More than 80% of infections are asymptomatic, ie without the appearance of symptoms, but with the formation of neutralizing type-specific antibodies.
Further notes
- In pregnancy, most enterovirus infections are mild or asymptomatic. Severe complications are very rare.
- Most newborns also show a mild course of disease. In very rare cases, systemic infection with fulminant (rapid and severe) courses is possible.
Atypical hand-foot-and-mouth disease (example of a case)
- Disseminated (“spread over the body”) skin lesions (neck and trunk; dorsum of hands and feet; lower legs and forearms): Erythematous papules, multiple partly grouped, partly confluent, partly solitary vesicles (blisters) on an erythematous (“reddened”) base; ulcerations (ulcer formations), formation of bullae (fluid-filled cavities; at least 1 cm in size), and eczematized plaques (areal or squamous substance proliferation of the skin)
- Onychomadesis (complete detachment of the nail plate from the nail bed).
- If necessary, generalized pruritus (itching distributed over the entire body).
- Severely reduced general condition with high fever up to 39 ° C, cephalgia and myalgia (headache and muscle pain) and marked fatigue.
- Coxsackie virus A6 variant
