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Article in English | WPRIM | ID: wpr-880323


BACKGROUND@#Severe hand-foot-and-mouth disease (HFMD) is a life-threatening contagious disease among young children and infants. Although enterovirus A71 has been well acknowledged to be the dominant cause of severe HFMD, there still remain other unidentified risk factors for severe HFMD. Previous studies mainly focused on identifying the individual-level risk factors from a clinical perspective, while rare studies aimed to clarify the association between regional-level risk factors and severe HFMD, which may be more important from a public health perspective.@*METHODS@#We retrieved the clinical HFMD counts between 2008 and 2014 from the Chinese Center for Disease Control and Prevention, which were used to calculated the case-severity rate in 143 prefectural-level cities in mainland China. For each of those 143 cities, we further obtained city-specific characteristics from the China City Statistical Yearbook (social and economic variables) and the national meteorological monitoring system (meteorological variables). A Poisson regression model was then used to estimate the associations between city-specific characteristics (reduced by the principal component analysis to avoid multicollinearity) and the case-severity rate of HFMD. The above analysis was further stratified by age and gender to examine potential modifying effects and vulnerable sub-populations.@*RESULTS@#We found that the case-severity rate of HFMD varied dramatically between cities, ranging from 0 to 8.09%. Cities with high case-severity rates were mainly clustered in Central China. By relating the case-severity rate to city-specific characteristics, we found that both the principal component characterized by a high level of social and economic development (RR = 0.823, 95%CI 0.739, 0.916) and another that characterized by warm and humid climate (RR = 0.771, 95%CI 0.619, 0.960) were negatively associated with the case-severity rate of HFMD. These estimations were consistent across age and gender sub-populations.@*CONCLUSION@#Except for the type of infected pathogen, the case-severity rate of HFMD was closely related to city development and meteorological factor. These findings suggest that social and environmental factors may also play an important role in the progress of severe HFMD.

Adolescent , Child , Child, Preschool , China/epidemiology , Cities/epidemiology , Female , Hand, Foot and Mouth Disease/virology , Humans , Incidence , Infant , Infant, Newborn , Male , Risk Factors
Article in Chinese | WPRIM | ID: wpr-879191


Antiviral Oral Liquid is modified on the basis of Baihu Decoction in Treatise on Febrility Diseases by ZHANG Zhongjing and Qingwen Baidu Yin in Qing Dynasty, with effects in clearing toxic heat, repelling dampness and cooling blood. It is widely used in clinical treatment of common colds, influenza and upper respiratory tract infection, mumps, viral conjunctivitis and hand-foot-mouth disease, with a good clinical efficacy and safety. Based on a questionnaire survey of clinicians and a systematic review of study literatures on Antiviral Oral Liquid, the international clinical practice guidelines development method was adopted to analyze the optimal available evidences and expert experiences in the "evidence-based, consensus-based and experience-based" principles. The consensus was jointly reached by more than 30 multidisciplinary experts nationwide, including clinical experts of traditional Chinese and Western medicine in the field of respiratory diseases and infectious diseases, and methodological experts. In the study, literatures were retrieved based on clinical problems in the clinical survey as well as PICO clinical problems. The GRADE system was used for the classification and evaluation of evidence, and fully combined with clinical expert experience, so as to reach expert consensus by the nominal grouping method. This expert consensus recommended or suggested indications, usage and dosage, course of treatment, intervention time for treatment, and the safety and precautions of Antiviral Oral Liquid for treatment of influenza, and can provide reference for the rational use of this drug in clinical practice.

Antiviral Agents/therapeutic use , Consensus , Hand, Foot and Mouth Disease , Humans , Influenza, Human/drug therapy , Medicine, Chinese Traditional
Arch. argent. pediatr ; 118(2): e199-e203, abr. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1100481


La enfermedad mano-pie-boca (EMPB) típica es exantemática, con sintomatología clásica de fiebre, exantema papulovesicular en las manos y los pies, asociada o no a herpangina. Es causada, principalmente, por enterovirus 71 y virus Coxsackie A16, miembros del género Enterovirus. En los últimos años, se han descrito brotes mundiales de EMPB con manifestaciones atípicas causadas, sobre todo, por el virus Coxsackie A6. La EMPB atípica se considera emergente con características clínicas y epidemiológicas peculiares: la afección de adultos, el predominio en invierno y un amplio espectro de manifestaciones clínicas en la extensión y la distribución de las lesiones. Las características morfológicas de las lesiones son muy variables: pueden simular varicela, impétigo o vasculitis.Se describe el caso de un niño de 4 años con EMPB atípica. Se detalla su forma de presentación, evolución clínica, metodología diagnóstica y terapéutica empleada.

Typical hand-foot-mouth disease (HFMD) is an exanthematous viral disease with a classic symptomatology of fever, papulovesicular rash on the hands and feet with or without herpangina. It is usually caused by enterovirus 71 and Coxsackievirus A16, members of the genus Enterovirus. Recently, worldwide outbreaks of HFMD with atypical manifestations caused by Coxsackievirus A6 have been described. Atypical HFMD is considered an emerging disease due to its peculiar clinical and epidemiological characteristics: it affects adults, has a wide spectrum of clinical manifestations in the extension and distribution of the lesions and occurs in winter. The morphological characteristics of the lesions are very variable and can be misdiagnosed as chickenpox, impetigo or vasculitis. Here we describe the symptoms, clinical evolution, diagnostic methodology and treatment employed on a 4-year-old male patient with atypical HFMD.

Humans , Male , Child, Preschool , Enterovirus A, Human/classification , Hand, Foot and Mouth Disease/diagnosis , Coxsackievirus Infections/epidemiology , Diagnosis, Differential , Genotype , Hand, Foot and Mouth Disease/therapy
Clinics ; 75: e1619, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133488


OBJECTIVE: We aimed to evaluate the association between platelet (PLT) count and the risk and progression of hand, foot, and mouth disease (HFMD). METHODS: In total, 122 HFMD patients and 40 healthy controls were enrolled in the study. The differences between variables among the different subgroups were compared. Logistic regression analyses were performed to assess the relationship between various parameters and HFMD risk/progression. Sensitivity analysis was conducted by detecting the trend of the association between PLT count quartiles and HFMD risk/progression. A generalized additive model was used to identify the nonlinear relationship between PLT count and HFMD risk/progression. The relationship between gender and PLT count as well as the risk/progression of HFMD was detected using a stratified logistic regression model. RESULTS: Significant differences were observed in terms of age, male/female ratio, white blood cell (WBC) count, and PLT count between patients with stage I-II, III-IV HFMD and healthy controls. Moreover, the alanine aminotransferase and magnesium levels between patients with stage I-II and III-IV HFMD significantly differed. Moreover, a significant difference was noted in the male/female ratio among the different PLT groups. The group with a low PLT count had a lower risk of HFMD progression than the group with a high PLT count (Q4) (p=0.039). Lower age, male gender, and WBC count were found to be associated with HFMD risk. Meanwhile, PLT count was correlated to HFMD progression. The sensitivity analysis yielded a similar result using the minimally adjusted model (p for trend=0.037), and minimal changes were observed using the crude and fully adjusted model (p for trend=0.054; 0.090). A significant nonlinear relationship was observed between PLT count and HFMD progression after adjusting for age, gender, and WBC (p=0.039). CONCLUSIONS: PLT was independently associated with HFMD progression in a nonlinear manner.

Humans , Male , Female , Child , Hand, Foot and Mouth Disease , Platelet Count , Logistic Models , China , Disease Progression , Leukocyte Count
Article in English | WPRIM | ID: wpr-828997


Objective@#We aimed to assess the features of notifiable infectious diseases found commonly in foreign nationals in China between 2004 and 2017 to improve public health policy and responses for infectious diseases.@*Methods@#We performed a descriptive study of notifiable infectious diseases among foreigners reported from 2004 to 2017 in China using data from the Chinese National Notifiable Infectious Disease Reporting System (NNIDRIS). Demographic, temporal-spatial distribution were described and analyzed.@*Results@#A total of 67,939 cases of 33 different infectious diseases were reported among foreigners. These diseases were seen in 31 provinces of China and originated from 146 countries of the world. The infectious diseases with the highest incidence number were human immunodeficiency virus (HIV) of 18,713 cases, hepatitis B (6,461 cases), hand, foot, and mouth disease (6,327 cases). Yunnan province had the highest number of notifiable infectious diseases in foreigners. There were different trends of the major infectious diseases among foreign cases seen in China and varied among provinces.@*Conclusions@#This is the first description of the epidemiological characteristic of notifiable infectious diseases among foreigners in China from 2004 to 2017. These data can be used to better inform policymakers about national health priorities for future research and control strategies.

Adolescent , Adult , Child , Child, Preschool , China , Epidemiology , Communicable Diseases , Epidemiology , Female , HIV Infections , Epidemiology , Hand, Foot and Mouth Disease , Epidemiology , Hepatitis B , Epidemiology , Humans , Incidence , Infant , Male , Middle Aged , Prevalence , Young Adult
Article in Chinese | WPRIM | ID: wpr-828414


The efficacy and safety of Xiao'er Chaigui Tuire Granules for the treatment of hand, foot and mouth disease were syste-matically evaluated. Four Chinese databases of CNKI, CBM, WanFang, VIP and four English databases of PubMed, Cochrane Library, EMbase, Web of Science were retrieved by computers. With Chinese and English words "Xiao'er Chaigui Tuire Granules" "hand, foot and mouth disease" as the subject and keywords, randomized controlled trials(RCT) for the effect of Xiao'er Chaigui Tui-re Granules alone and combined with Western medicine in the treatment of hand, foot and mouth disease were retrieved, and the retrieval time was generally from the establishment of the database to January 20, 2020. Then all the relevant documents that meet the requirements and be included in the quality evaluation standard were screened out, relevant baseline data information was extracted, and a final evaluation was conducted for the quality of relevant literatures. The quality evaluation was conducted by the latest RevMan 5.3 software version-based tools. The reliability of the data relating to the results of the literatures was analyzed by statistical data. A total of 7 RCTs were included. The total sample size was 619, including 321 in the experimental group and 298 in the control group. Meta-analysis results show that: Xiao'er Chaigui Tuire Granules could improve the total clinical effectiveness(RR=1.28, 95%CI[1.11, 1.46], P=0.000 4; RR=1.62, 95%CI[1.06, 2.48], P=0.02); Xiao'er Chaigui Tuire Granules combined with Western medicine could significantly shorten the healing time of oral ulcers in children with hand, foot and mouth disease(MD=-1.11, 95%CI[-1.44,-0.78], P<0.000 01; MD=-2.13, 95%CI[-2.37,-1.89], P<0.000 01; MD=-1.10, 95%CI[-1.38,-0.82], P<0.000 01); on the basis of conventional treatment, Xiao'er Chaigui Tuire Granules combined with Western medicine could reduce the fever time(MD=-1.21, 95%CI[-2.15,-0.27], P=0.01; MD=-1.93, 95%CI[-2.35,-1.51], P<0.000 01; MD=-2.00, 95%CI[-2.60,-1.40], P<0.000 01), with no serious adverse reaction. The results showed that, in the treatment of hand, foot and mouth disease, compared with the conventional treatment method of Western medicine alone, the combined use of Xiao'er Chaigui Tuire Granules had more obvious advantage in effectively shortening the healing time of oral ulcers in children and effectively reducing the antipyretic time. Moreover, it had a better clinical efficacy in treating the patients with hand, foot and mouth disease in the early stage in terms of the improvement and control of symptoms and pathology, with a significantly increased effectiveness and no serious adverse reaction. It could be considered to be combined with therapies based on syndrome differentiation. However, due to the small sample size of clinical studies currently included, and the low quality of clinical studies further included, the quality of the studies included was low, which affected the scientific reliability and quality of the conclusions of the study. Therefore, further clinical results are still required for further confirmation.

Child , Drugs, Chinese Herbal , Hand, Foot and Mouth Disease , Humans , Reproducibility of Results , Treatment Outcome
Article in Chinese | WPRIM | ID: wpr-828413


Lanqin Oral Liquid is a Chinese patent medicine which contains Isatidis Radix, Scutellariae Radix, Gardeniae Fructus, Phellodendri Chinensis Cordex and Sterculiae Lychophorae Semen. It is known for the pharmaceutical effect on the upper respiratory tract infection as it is beneficial for relieving the swelling of pharyngeal. In terms of Chinese medicine, it offers a clearing action on heat and toxic materials. According to the principle of Chinese medicine, different diseases can be treated by the same therapy as long as they have the same syndrome. Based on this unique diagnosis and treatment approach, Lanqin Oral Liquid was applicable to diseases with syndrome of excessive heat in lung and stomach. It was therefore commonly be used in the therapeutic approach towards hand, foot and mouth disease as well. However, no systematic evaluation had yet been done to verify this Chinese patent medicine on the efficacy and clinical safety for the disease. In order to achieve the manner of evidence-based medicine, this study had adopted a systematic review and Meta-analysis to evaluate the efficacy and safety of Lanqin Oral Liquid in the treatment of hand, foot and mouth disease. All related randomized controlled trials(RCT) were searched in the following data bases: CNKI, WanFang, VIP, SinoMed, Cochrane Library and PubMed. Based on the method provided by the Cochrane collaboration, the study assessed the quality of papers selected and RevMan 5.3 software was used to perform Meta-analysis. Totally 24 studies were included with 3 491 sample size, which 1 826 cases were treatment group and 1 665 cases were control group. From the results of Meta-analysis, the total effective rate of combination of Lanqin Oral Liquid and Western medicines shown better than Western medicine alone in the treatment for hand, foot and mouth di-sease, but mild adverse event were also found(RR=1.20,95%CI[1.16,1.23],P<0.000 01). Incidence of adverse reaction between experimental and control group was statistically insignificant(RR=1.16, 95%CI[0.79, 1.70], P=0.45). No conclusion was able to made in terms of the remission time of clinical symptoms, as the studies included were not qualified for Meta-analysis. As a matter of fact, the number of existing studies related to the Lanqin Oral Liquid were limited with poor quality as well. In other words, high quality studies were essential to further evaluate the efficacy and safety of Lanqin Oral Liquid.

Drugs, Chinese Herbal , Hand, Foot and Mouth Disease , Humans , Medicine, East Asian Traditional , Nonprescription Drugs , Research Design
Article in Chinese | WPRIM | ID: wpr-826724


OBJECTIVE@#To observe the effect of acupuncture combined with conventional symptomatic and supportive treatments on swallowing function and nutritional status in children with severe hand foot and mouth disease complicated with dysphagia.@*METHODS@#A total of 68 children with severe hand foot and mouth disease complicated with dysphagia were randomized into an observation group and a control group, 34 cases in each one. Symptomatic and supportive treatments such as lowering temperature, tranquilizing and mechanical ventilation were adopted in the control group. On the basis of the treatments in the control group, acupuncture was applied at Lianquan (CV 23), Jialianquan (Extra), cervical Jiaji (EX-B 2), Fengfu (GV 16), Fengchi (GB 20), Yamen (GV 15), scalp motor and sensory areas in the observation group, once a day, 6 times a week, one month as a course and totally 3 courses were required. Time spent on restoring swallowing function was observed in both groups. Besides, score of dysphagia disorder survey (DDS) and nutritional status were evaluated before and after treatment, and the clinical effects were compared.@*RESULTS@#The total effective rate was 91.2% (31/34) in the observation group, which was superior to 73.5% (25/34) in the control group (<0.05). The time of restoring swallowing function in the observation group was advanced than the control group (<0.05). Compared before treatment, the DDS scores after treatment were decreased in both groups, and the reduction in the observation group was larger than the control group (all <0.05). After the treatment, the normal rate of nutritional status was 61.8% (21/34) in the observation group, which was superior to 32.4% (11/34) in the control group (<0.05).@*CONCLUSION@#On the basis of conventional treatment, acupuncture can effectively treat the severe hand foot and mouth disease complicated with dysphagia, improve the swallowing function and nutritional status.

Acupuncture Points , Acupuncture Therapy , Child , Deglutition Disorders , Therapeutics , Hand, Foot and Mouth Disease , Therapeutics , Humans , Treatment Outcome
Article in Chinese | WPRIM | ID: wpr-878837


This paper aimed to investigate the active components and molecular mechanism of Xiao'er Resuqing Oral Liquid on hand, foot and mouth disease(HFMD) based on network pharmacology and molecular docking methods. The potential active components of 8 herbs in Xiao'er Resuqing Oral Liquid were selected through Traditional Chinese Medicine Systems Pharmacology Database(TCMSP), Batman database and relevant literature consultation. Then related targets for the medicine were analyzed through PubChem and Swiss Target Prediction database, while related targets for HFMD were analyzed through GeneCards platform. The common targets for medicine and disease were put into STRING database to obtain the potential targets of Xiao'er Resuqing Oral Liquid for treatment of HFMD. The Cytoscape software was used to establish the "herbs-components-targets-disease" network. The protein-protein interaction(PPI) network was constructed based on STRING platform and Cytoscape software to screen the core targets. Based on Metascape platform, GO function enrichment analysis and KEGG signal pathway enrichment analysis were carried out. The main active components and potential key targets of Xiao'er Resuqing Oral Liquid were verified by molecular docking with Autodock vina 1.1.2 software. A total of 118 potential active components and 123 potential targets for treatment of HFMD were collected. PPI network indicated a total of 23 key targets, such as AKT1, MAPK1, IL6, VEGFA, EGFR, TNF, HRAS, CCND1, and CXCL8. GO function enrichment analysis results showed that there were 381 GO biological processes, 127 GO cellular components, and 117 GO molecular functions(P<0.01). KEGG enrichment analysis showed that 116 signal pathways were obtained(P<0.01), and the results showed that it was mainly associated with TNF signal pathway, IL-17 signal pathway, inflammatory mediator regulation of TRP channels, and cytokine-cytokine receptor interaction. Molecular docking results showed that the main active components all had a high binding ability with the main potential key targets. This study preliminarily investigated the multi-pathways, multi-targets and multi-components molecular mechanism of Xiao'er Resuqing Oral Liquid for treatment of HFMD, providing theoretical references for further researches on its active components and action mechanism.

Drugs, Chinese Herbal , Hand, Foot and Mouth Disease , Humans , Medicine, Chinese Traditional , Molecular Docking Simulation , Signal Transduction
Rev. argent. microbiol ; 51(2): 140-143, jun. 2019. ilus, tab
Article in English | LILACS | ID: biblio-1013363


We present two groups of cases of atypical hand, foot, and mouth disease (HFMD) caused by Coxsackievirus A6 (CV-A6) detected in Argentina in 2015. The first group involved 14 patients from Chubut province and the second group affected 12 patients from San Luis province. Molecular analysis of the complete VP1 protein gene revealed the circulation of E2 sublineage, the most predominant worldwide. To our knowledge, this is the first report of CV-A6 infections associated with atypical HFMD in Argentina and South America.

Se describen dos grupos de casos de enfermedad de mano-pie-boca (HFMD) atípica causada por el virus Coxsackie A6 (Coxsackievirus A6, CV-A6) detectados en Argentina en el año 2015. El primero de los grupos involucró a 14 pacientes de Chubut y el segundo a 12 pacientes de San Luis. El análisis molecular del gen de la proteína VP1 completa reveló la circulación del sublinaje E2, el predominante a nivel global. Hasta donde sabemos, este es el primer reporte de infecciones CV-A6 asociadas con HFMD atípica en Argentina y Sudamérica.

Enterovirus/pathogenicity , Hand, Foot and Mouth Disease/etiology , Hand, Foot and Mouth Disease/microbiology , Hand, Foot and Mouth Disease/epidemiology
Arch. argent. pediatr ; 117(1): 59-62, feb. 2019. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-983782


La enfermedad boca-mano-pie puede presentarse con formas atípicas, con lesiones más generalizadas y morfología diferente a la forma clásica. A veces, incluso simula otras enfermedades víricas. En las formas atípicas, existe la tendencia a afectar a las zonas de traumatismo o inflamación. Se presenta el caso de un niño de 2 años con antecedente de atopia, que consultó por presentar lesiones papulosas y vesiculosas umbilicadas que afectaban a la zona perioral, los miembros superiores e inferiores, con predominio en las zonas de presión y de dermatitis atópica previa. Aunque clínicamente se diagnosticó eczema herpético, las pruebas complementarias fueron negativas para herpes virus. Sin embargo, la reacción en cadena de la polimerasa del contenido de una vesícula, del exudado faríngeo y de heces fue positiva para enterovirus.

Hand-foot-mouth disease can present atypically, including forms with more numerous lesions and/or morphologically different from the classic presentation. It may even mimic other viral diseases. We present the case of a 2-year-old child previously diagnosed with atopic dermatitis, who presented with papules and umbilicated vesicles affecting the perioral area and limbs, predominantly in pressure areas, as well as in areas with previous atopic lesions. Although he was clinically diagnosed with herpetic eczema, tests results were negative for herpes virus. However, positive entorovirus polymerase chain reaction results were obtained from the content of a vesicle, a pharyngeal exudate and a stool sample.

Humans , Male , Child, Preschool , Blister , Enterovirus , Exanthema , Hand, Foot and Mouth Disease
Medisan ; 23(1)ene.-feb. 2019. ilus
Article in Spanish | LILACS | ID: biblio-990182


Se presenta el caso clínico de un lactante de 9 meses de edad, atendido en el cuerpo de guardia del Policlínico Docente José Martí de la provincia de Santiago de Cuba, por presentar lesiones exantemáticas y eritematosas en la piel, con ampollas alrededor de la boca, así como en manos, piernas y ambos pies, además de fiebre. Se le diagnosticó la enfermedad de boca, mano y pie, teniendo en cuenta la clínica y el incremento de esta afección trasmitida por el virus de Coxsackie en el municipio, por lo cual fue ingresado en el hogar, con vigilancia y seguimiento por su médico y enfermera de la familia, quienes indicaron las medidas para el control higiénico sanitario y de sostén que deben conocerse y aplicarse en el medio familiar para disminuir el riesgo de la infección.

The case report of a 9 months of age infant assisted in the emergency room of José Martí Teaching Polyclinic in Santiago de Cuba is presented, due to exanthematic and erythematous lesions in the skin, with bladders around the mouth, as well as in hands, legs and both feet, besides fever. The mouth, hand and foot disease was diagnosed, keeping in mind the clinic and the increment of this disorder transmitted by the Coxsackie virus in the municipality, reason why he was admitted at home, with medical supervision and followed by the family nurse and physician who indicated the measures for the health control that should be known and applied in the family to decrease the risk of infection.

Humans , Male , Infant , Coxsackievirus Infections , Hand, Foot and Mouth Disease , Erythema Infectiosum , Exanthema
Rev. chil. dermatol ; 35(4): 150-153, 2019. ilus
Article in Spanish | LILACS | ID: biblio-1120284


La enfermedad de pie, mano boca es una patología frecuente de observar en niños menores de 5 años, generalmente producida por virus Coxsackies y Enterovirus. Existen presentaciones atípicas debido a serotipos recientemente descritos de estos virus, algunos de ellos se han reportado en pacientes adultos. Se presenta caso de paciente masculino de 19 años, con antecedentes de dermatitis seborreica facial en tratamiento, que desarrolla una presentación atípica del síndrome pie, mano boca en contexto de un brote de esta patología en su academia militar. Luego del análisis epidemiológico, clínico e histopatológico, se diagnostica eccema coxsackium, una patología infrecuente en este grupo etario que contiene algunas particularidades destacables en relación con su manejo y estudio.

The hand mouth foot syndrome is a common pathology observed in children under 5 years, usually caused by coxsackie virus and enterovirus. There are exuberant clinical presentations, due to infrequent and emerging serotypes of these viruses, some of them manifesting in adult patients. A case of a 19 year old patient is presented, with a history of seborrheic dermatitis of the face and scalp in treatment, who develops an atypical clinical presentation of the hand foot mouth syndrome, intensely affecting the areas of seborrheic dermatitis on the face, in the context of an outbreak of this pathology in his military academy. After the epidemiological, clinical and histopathological analysis, eczema coxsackium is diagnosed, an infrequent pathology in this age group that contains some remarkable peculiarities in relation to its management.

Humans , Male , Adult , Coxsackievirus Infections/diagnosis , Coxsackievirus Infections/pathology , Eczema , Hand, Foot and Mouth Disease/diagnosis , Hand, Foot and Mouth Disease/pathology
Medwave ; 19(7): e7683, 2019.
Article in English, Spanish | LILACS | ID: biblio-1015277


La enfermedad de mano-pie-boca es una patología originada en la mayoría de los casos por el virus coxsackie A tipo 16, aunque también puede ser ocasionada por otras cepas de la familia de los coxsackievirus. Dicho virus se propaga principalmente por vía fecal oral y, en menor proporción, por secreciones. Se presenta principalmente en verano, siendo frecuente en niños menores de 10 años. Dentro de dicha enfermedad las lesiones mucocutáneas que evolucionen en necrosis son poco frecuentes, constituyéndose en una complicación severa que requiere hospitalización. En el presente artículo se reporta un caso con diagnóstico de enfermedad mano-pie-boca, que evolucionó hacia lesiones mucocutáneas necróticas, mostrando una respuesta favorable a una terapia de soporte de aciclovir, líquidos y electrolitos.

In most cases, the cause of hand, foot, and mouth disease (HFMD) is coxsackievirus A type 16. The infection can also be caused by other strains of coxsackievirus, spreading mainly by the oral-fecal route, while it is less likely to be transmitted through secretions. HFMD occurs mainly in summer and is more common in children under ten. Skin lesions develop during the disease but rarely become necrotic. When present, they are a severe complication requiring hospitalization. This paper reports the case of a patient with HFMD who developed necrotic mucocutaneous lesions that responded favorably to intravenous acyclovir, fluids, and electrolyte support therapy.

Humans , Female , Child , Antiviral Agents/administration & dosage , Acyclovir/administration & dosage , Hand, Foot and Mouth Disease/diagnosis , Electrolytes/administration & dosage , Fluid Therapy/methods , Hand, Foot and Mouth Disease/pathology , Hand, Foot and Mouth Disease/therapy , Necrosis
Article in Chinese | WPRIM | ID: wpr-775104


OBJECTIVE@#To study the clinical effect of carvedilol in the treatment of children with severe hand-foot-mouth disease (HFMD) caused by enterovirus 71 (EV71) infection.@*METHODS@#A retrospective analysis was performed for the clinical data of 86 children with severe HFMD caused by EV71 infection who were admitted to the hospital from April 2016 to August 2017. According to whether carvedilol was used, the children were divided into conventional treatment group with 51 children and carvedilol treatment group with 35 children. A total of 56 healthy children who underwent physical examination at the outpatient service during the same period were enrolled as the control group. The two treatment groups were compared in terms of clinical features and levels of catecholamines (norepinephrine, adrenaline and dopamine), and the levels of catecholamines were compared between these two treatment groups and the control group.@*RESULTS@#Before treatment, the conventional treatment group and the carvedilol treatment group had significantly higher levels of norepinephrine and adrenaline than the control group (P<0.05). After treatment, both the conventional treatment group and the carvedilol treatment group had significant reductions in norepinephrine, adrenaline, blood glucose, systolic pressure, diastolic pressure, heart rate, body temperature and leukocyte count (P<0.05). Compared with the conventional treatment group, the carvedilol treatment group had significantly lower dopamine level, blood glucose, heart rate and respiratory rate after treatment (P<0.05).@*CONCLUSIONS@#Changes in norepinephrine and adrenaline might be involved in the pathogenesis of severe HFMD caused by EV71 infection. Carvedilol, in addition to the conventional treatment, can improve respiration, heart rate and blood glucose in children with severe HFMD caused by EV71 infection.

Carvedilol , Therapeutic Uses , Child , China , Enterovirus A, Human , Enterovirus Infections , Hand, Foot and Mouth Disease , Drug Therapy , Humans , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-781711


OBJECTIVE@#To study the clinical value of lymphocyte subsets, immunoglobulins, and complement C3 and C4 in the evaluation of immune status in children with hand-foot-mouth disease (HFMD).@*METHODS@#A total of 282 children with HFMD were enrolled as the HFMD group, and 130 healthy children were enrolled as the healthy control group. The percentages of peripheral CD3, CD4, and CD8 T lymphocytes, CD19 B lymphocytes, and CD56 natural killer cells were measured. The CD4/CD8 ratio was calculated. The levels of immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G (IgG), and complement C3 and C4 were measured.@*RESULTS@#The multivariate analysis showed that compared with the healthy control group, the HFMD group had significantly lower percentages of CD3, CD4, and CD8 T lymphocytes and levels of complement C3 and C4 (P<0.05), as well as significantly higher percentage of CD56 natural killer cells and level of IgG (P<0.05). The individual effect analysis showed that the children aged 0-3 years in the HFMD group had a significantly higher CD4/CD8 ratio than the healthy control group (P<0.05); boys aged 0-3 and ≥3 years in the HFMD group had a significantly higher level of IgM than the healthy control group (P<0.05); boys aged ≥3 years and girls aged 0-3 years in the HFMD group had a significantly lower level of IgA than the healthy control group (P<0.05).@*CONCLUSIONS@#Cellular and humoral immunity disorders are observed in children with HFMD. The monitoring of lymphocyte subsets and immunoglobulin levels can provide a laboratory basis for immune status assessment in children with HFMD.

Child, Preschool , Complement C3 , Complement C4 , Female , Hand, Foot and Mouth Disease , Humans , Immunoglobulins , Infant , Infant, Newborn , Killer Cells, Natural , Lymphocyte Count , Lymphocyte Subsets , Male
Rev. cuba. pediatr ; 90(3): 1-12, jul.-set. 2018. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-978447


Introducción: la enfermedad boca, mano, pie es una enfermedad febril eruptiva provocada por la infección por los virus Coxsackie, consistente en fiebre, exantema pápulo-vesicular en las manos, los pies y un enantema ulceroso en la boca. Objetivos: indagar la etiología viral y describir las características clínico epidemiológicas de la entidad. Métodos: estudio descriptivo prospectivo en 54 pacientes menores de 18 años, diagnosticados con la enfermedad boca, mano, pie, atendidos en el Hospital Pediátrico Docente del Cerro, de septiembre a noviembre de 2017. Se incluyeron aquellos con lesiones vesiculares o pápulas vesiculares, distribuidas en la piel y úlceras en la mucosa oral; y se excluyeron los pacientes con otras entidades exantemáticas o vesiculares. Las variables investigadas resultaron: la edad, el sexo, los signos, los síntomas clínicos de infección, el leucograma y el estudio virológico. La selección de la muestra fue de manera no probabilística consecutiva. Los datos se procesaron por el paquete estadístico XLSTAT con análisis univariado. Resultados: el grupo entre 1-3 años obtuvo 53,7 por ciento, y el sexo masculino el 68,5 por ciento. Las lesiones cutáneas fueron más frecuentes en la cara, las extremidades, los glúteos y el tronco (68,6 por ciento), seguido de la zonas de la cara, las extremidades y el tronco (29,6 por ciento). El enantema fue apreciado en el 48,1 por ciento, la fiebre en el 61,1 por ciento, la fiebre más secreción nasal en el 44,4 por ciento y el prurito en el 70,3 por ciento. El conteo leucocitario alcanzó 11,1 x 109 células. Los polimorfonucleares obtuvieron promedio de 37,9 y los linfocitos 70,3. En 49 de los 54 pacientes se aisló el virus Coxsackie A6. Conclusiones: se describe la enfermedad boca, mano, pie en forma atípica, cuyo cuadro clínico coincide con lo aparecido en la literatura(AU)

Introduction: mouth, hand and foot disease is an eruptive febrile illness caused by the infection of Coxsackie viruses, and it consists in fever, papulo-vesicular exanthema in the hands, feet and an ulcer enanthema in the mouth. Objectives: to investigate the viral etiology and describe the clinical epidemiological characteristics of the entity. Methods: prospective descriptive study in 54 patients under 18 years old diagnosed with mouth, hand and foot disease, and whom were attended at the Pediatric Teaching Hospital of Cerro from September to November 2017. Those with vesicular lesions or vesicular papules distributed in the skin, and ulcers in the oral mucosa were included in the research; and patients with other exanthematic or vesicular entities were excluded. The variables investigated were: age, sex, signs, clinical symptoms of infection, leukogram and virological study. The selection of the sample was consecutive non-probabilistic. The data was processed by the XLSTAT statistical package with univariate analysis. Results: the group from 1 to 3 years old represented the 53.7 percent, and the male sex the 68.5 percent y. Skin lesions were more frequent on the face, extremities, buttocks and trunk (68.6 percent), followed by facial, limbs and trunk areas (29.6 percent). Enanthem was visible in 48.1 percent, and fever appeared in 61.1 percent, fever plus nasal discharge in 44.4 percent and itching in 70.3 percent y The leukocyte count reached 11.1 x 109 cells. Polymorphonuclear cells obtained an average of 37.9 and lymphocytes of 70.3. In 49 of the 54 patients the Coxsackie A6 virus was isolated. Conclusions: mouth, hand, and foot disease is described in an atypical form, whose clinical manifestations coincide with what appeared in the literature(AU)

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Virology/methods , Hand, Foot and Mouth Disease/etiology , Hand, Foot and Mouth Disease/epidemiology , Epidemiology, Descriptive , Prospective Studies
Rev. cuba. pediatr ; 90(3): 1-8, jul.-set. 2018. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-978455


Introducción: la onicomadesis es el desprendimiento completo y espontáneo de la uña desde su extremo proximal, sin dolor o inflamación, consecutivo a la detención mitótica de la matriz ungular que conlleva a un cambio de su función. Objetivo: describir una serie de casos de onicomadesis atendidos en la consulta de Dermatología del Hospital Pediátrico Docente del Cerro, entre noviembre y diciembre del año 2017, después de presentar un cuadro clínico compatible con enfermedad boca, mano, pie, con la finalidad de contribuir al conocimiento de esta patema. Presentación de los casos: las edades estuvieron comprendidas en un rango entre 1 y 12 años, con solo 3 pacientes correspondientes al sexo masculino y solo uno con el color de la piel negra. Los días previos al padecimiento de la enfermedad boca, mano, pie se enmarcan entre 15 y 47 días de haber tenido los síntomas que indujeron al diagnóstico del citado morbo. El estudio virológico se efectuó en dos pacientes con presencia del Coxsackie A6. La evolución resultó satisfactoria en todos los casos. Conclusiones: los hallazgos, en general, coinciden con los mencionados en la literatura. Todos los pacientes presentaron semanas anteriores signos y síntomas compatibles con enfermedad boca, mano, pie. Es necesario orientar a los padres de los enfermos con este morbo, la posibilidad de la ocurrencia de onicomadesis como complicación, cuyo tratamiento es sintomático, seguido de buen pronóstico, para evitar la ansiedad familiar y los gastos de recursos innecesarios(AU)

Introduction: onychomadesis is the total and spontaneous detachment of the nail from its proximal end, without pain or inflammation, and following the mitotic halting of the nail matrix that leads to a change in its function. Objective: to describe a series of cases of onychomadesis attended in the Dermatology clinic of the Pediatric Teaching Hospital of Cerro, in the period of November to December of 2017, after presenting clinical manifestations compatible with mouth, hand, and foot disease, and in order to contribute to the knowledge of this pathology. Presentation of cases: ages were among 1 and 12 years old, with only 3 patients corresponding to the male sex and only one with black skin. The days before presenting symptoms of mouth, hand, and foot disease were between 15 and 47 days after having the symptoms that led to the diagnosis of the aforementioned disease. The virological study was carried out in two patients with the presence of Coxsackie A6. The evolution was satisfactory in all cases. Conclusions: in general the findings coincide with those mentioned in the literature. All patients presented previous signs and symptoms compatible with mouth, hand, and foot disease in the previous weeks. It is necessary to guide the parents of patients with this disease on the possibility of the onychomadesis occurrence as a complication, whose treatment is symptomatic, followed by a good prognosis to avoid family anxiety and the expense of unnecessary resources(AU)

Humans , Male , Female , Infant , Child, Preschool , Child , Hand, Foot and Mouth Disease/complications , Hand, Foot and Mouth Disease/prevention & control , Nail Diseases/complications , Nail Diseases/etiology , Onychomycosis/complications
Rev. chil. pediatr ; 89(3): 380-383, jun. 2018. graf
Article in Spanish | LILACS | ID: biblio-959537


INTRODUCCIÓN: Las alteraciones ungueales en niños provocan gran ansiedad en los padres y múltiples consultas en su mayoría innecesarias. La onicomadesis corresponde al despegamiento completo e indoloro de la lámina ungueal desde el pliegue proximal. Este hallazgo ungueal autoresolutivo se ha descrito como una complicación tardía de la enfermedad pie-mano-boca, exantema viral frecuente en la edad pediátrica. OBJETIVO: Reportar un caso pediátrico clásico de enfermedad pie-mano-boca que evolucionó con onicomadesis y revisión de la literatura. CASO CLÍNICO: Paciente masculino de 3 años de edad, con cuadro agudo de microampollas eritematosas, peribucales en un comienzo, luego brazos y manos, glúteos, muslo y pies, asintomático y sin compromiso del estado general. Se reali za diagnóstico clínico de enfermedad pie-mano-boca. Evoluciona con resolución total de lesiones cutáneas , pero al mes, desprendimiento completo de uñas, las que se recuperan con posterioridad. CONCLUSIÓN: El reconocimiento de la asociación entre enfermedad pie-mano-boca con onicomadesis nos permite orientar a los padres sobre un fenómeno benigno y transitorio que puede ocurrir como parte de la evolución de esta virosis, evitando así la ansiedad, derivación y tratamientos innecesarios.

INTRODUCTION: Nail alterations in children are an important cause of parent anxiety and derive in multiple and unnecessary consultations. The onychomadesis corresponds to the complete and pain less detachment of the nail plate from the proximal fold. This self-resolving nail finding has been described as a late complication of hand-foot-mouth disease, a frequent viral exanthema in the pedia tric age. OBJECTIVE: To describe a classic pediatric case of hand-foot-mouth disease with subsequent onychomadesis. CLINICAL CASE: A 3-years-old male patient with an acute presentation of acute erythe matous perioral papulovesicles, which extend to upper extremities and hands, buttocks, thighs and feet, asymptomatic, and without compromising general condition. Skin lesions resolve completely, but after one month, he develops detachment of the nails, with subsequent complete recovery. CONCLUSIONS: The recognition of this association will allow primary care physicians to guide the parents about a benign and self-resolving process that may occur as part of the evolution of hand-foot-mouth disease, thus avoiding unnecessary anxiety, referral and treatments.

Humans , Male , Child, Preschool , Hand, Foot and Mouth Disease/diagnosis , Nail Diseases/etiology , Hand, Foot and Mouth Disease/complications