Author: Tay Xue Chao Brian Diaz / Editor: Nick Tilbury / Codes: DC1, DP2, IP1, SLO1, SLO5 / Published: 25/02/2021
An 11-month-old boy is brought in by his worried mother because he has developed a rash around his mouth, hands, and feet. His mother says that he is more irritable, is feeding less but still drinking good amounts, and has an intermittent fever. He is still passing urine normally, has no past medical conditions, and was born at term with no complications. His immunisations are up to date.
Clinically, he is cheerful, interacting appropriately, and playing with toys that are presented to him by the nurses. His observations are as follows: Heart rate 130, Respiratory rate 30, Temperature 37.4 degrees Celsius and Oxygen saturations 96% on air.
You note that there are small vesicles and ulcers in and around the mouth and palate. There are also flat pink patches and elongated greyish blisters on the dorsal and palmar surfaces of the hands and feet as well as red macules and papules on the buttocks and arms.
The rest of the examination is unremarkable.


You diagnose hand, foot and mouth disease (HFMD), otherwise known as enteroviral vesicular stomatitis.
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Question 1 of 3
1. Question
What organism most commonly causes hand, foot and mouth disease?
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Question 2 of 3
2. Question
You advise the parents that this is a self-limiting viral illness and give them safety-netting advice before discharging them home. The boy’s mother asks if there are any special precautions that she should take to minimise transmission.
What advice should you give her?
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Question 3 of 3
3. Question
After three days, the child returns and is more unwell than before. He is lethargic, not eating and drinking at all, and has not passed urine in 24 hours. You decide to admit him.
What is the most common complication of hand, foot and mouth disease?
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Module Content
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8 responses
Thank you.
really good case
Useful info in daily Peads ED
Very informative and useful learning bite.
Great
good case
very good and to the point
Great recap
Great Revision