Living A Rash Hand-To-Mouth Existence

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.