ABSTRACT
Red Baby Syndrome is a new disease seen in infants and young children. Dramatic onset of clinical symptoms with high intensity, short duration and lack of similarity with other cutaneous lesions makes it distinct. Of 50 such patients studied over a period of 5 years, half were below one year of age. Abrupt onset of high fever and generalized erythema involving the entire skin, which is swollen and tender is characteristic. These children were highly irritable and had paradoxical cry when cuddled. Rapid resolution of symptoms occurred in 7-10 days with extensive desquamation. Routine investigations were normal, C-reactive protein was raised only in 10 patients. Human Parvo virus B-19 IgM antibodies were positive in 15 out of 24 patients. Real time polymerase chain reaction was positive for human parvovirus B 19 DNA in one. Histopathological changes in the skin biopsy showed post infectious vascular injury pattern.
Subject(s)
Antibodies, Viral/blood , Antigens, Viral/immunology , C-Reactive Protein/metabolism , Child, Preschool , DNA, Viral/analysis , Erythema/genetics , Erythema/immunology , Erythema/pathology , Female , Humans , India/epidemiology , Infant , Infant, Newborn , Male , Parvoviridae Infections/genetics , Parvoviridae Infections/pathology , Parvovirus B19, Human/genetics , Parvovirus B19, Human/immunology , Parvovirus B19, Human/isolation & purification , Polymerase Chain Reaction , Skin/pathology , SyndromeABSTRACT
OBJECTIVE: Hand-Foot-and-Mouth Disease (HFMD) is a mild exanthematous illness seen worldwide, affecting mainly children under ten years of age. The causative agents were initially Coxsackie virus type A 16 and related serotypes. The situation changed drastically about thirty years ago with the advent of a new aetiological agent, Enterovirus type 71 (EV 71), which has caused very large outbreaks with severe complications and many deaths. METHODS: The authors report an outbreak of papulovesicular lesions on the skin and oral mucosa compatible with the diagnosis of HFMD in children in and around Calicut in October 2003. Clinical and laboratory study in collaboration with the National Institute of Communicable Diseases, Delhi. Eighty one children with the syndrome were examined and followed up from October 2003 to February 2004, when the outbreak subsided. RESULT: The outbreak was mild and all children recovered within 1 to 2 weeks. CONCLUSION: Acute and convalescent paired serum samples collected from 19 patients were examined at the NICD for IgM antibody against EV 71 by microneutralisation test in cell culture. All the paired samples tested showed significant rise in titre of antibodies, confirming the diagnosis of EV 71 infection in each of them.