What are the symptoms and manifestations of hand, foot and mouth disease in children? When is the peak period of hand, foot and mouth disease?

Hand, foot and mouth disease is a common disease that occurs frequently in infants and young children under the age of 5. Summer and autumn are the peak seasons for the disease, so parents should pay more attention. So, how should children undergo physical examinations if they have hand, foot and mouth disease?

If children have hand, foot and mouth disease, they should go to the hospital for treatment as soon as possible. What is hand, foot and mouth disease in children? What are the physical examination items for hand, foot and mouth disease in children? Let's take a look below.

What are the common symptoms of hand, foot and mouth disease?

The incubation period of hand, foot and mouth disease is generally about 2-10 days. The external manifestations in the initial stage are similar to common cold and fever, but as the disease progresses, some specific characteristics will appear.

Common symptoms

As the name suggests, the most obvious symptoms of hand, foot and mouth disease appear on the hands, feet and mouth. Herpes similar in size and color to rice grains will appear in these three affected areas. Children can feel pain, and some children may also develop blisters on the buttocks or anus.

The child may also have a low-grade fever (around 38°C) and a rash, but these symptoms are usually not serious and will heal naturally within 1-2 weeks without any sequelae. A persistent low-grade fever may cause the baby to have a loss of appetite, dizziness, headaches, and occasional coughing and runny nose.

Symptoms of severe cases

A very small number of children with hand, foot and mouth disease will develop complications of the respiratory, nervous or circulatory systems. Among the more serious symptoms are meningitis, encephalomyelitis, myocarditis, pulmonary edema, circulatory failure, etc.

1. Symptoms of respiratory problems are very obvious. The baby's lung function deteriorates, breathing becomes rapid or difficult, and symptoms similar to suffocation may occur. In severe cases, the baby may foam at the mouth or spit blood.

2. Babies whose nervous systems are affected will become distracted, suffer from nausea, vomiting, drowsiness, etc., and have some uncontrollable limb reactions, such as convulsions and weakness in the limbs, etc. In severe cases, they may suffer from cerebral edema, brain hernia, etc.

3. Although the abnormal manifestations of the circulatory system are not obvious, they should be given enough attention. If the baby's limbs begin to become cold, the face becomes pale, and the heartbeat becomes disordered, the baby should be sent to the hospital for treatment in time.

Although severe cases of hand, foot and mouth disease rarely occur, we have to prevent it since there is such a possibility. If the baby is infected with the virus, mothers must not relax their vigilance and observe the child's condition at all times. If there is any abnormality, send the child to the hospital for treatment in time.

Laboratory tests

1. Peripheral blood leukocytes

In most cases, the total white blood cell count and neutrophil count are normal. In severe cases, the white blood cell count may be significantly increased.

2. Blood biochemical examination

Some cases may have mild elevations in ALT, AST, and CK-MB, and severe cases may have elevated blood sugar.

3. Etiological examination

Specific EV71 nucleic acid is positive or EV71 virus is isolated.

4. Serological examination

The specific EV71 antibody test is positive. The complement test is the most sensitive, and a positive result can be obtained 10 to 20 days after the onset of the disease.

5. Cerebrospinal fluid examination

The appearance is clear, the pressure is increased, the leukocytosis is increased (in critical cases, the multinuclear cells may be more than the monocytes), the protein is normal or slightly increased, and the sugar and chloride are normal. When there are complications of the central nervous system, the cerebrospinal fluid cell count may increase and the protein may rise.

6. Confirmation

On the basis of clinical diagnosis, a positive EV71 nucleic acid test, isolated EV71 virus or positive EV71IgM antibody test, or a more than 4-fold increase in EV71IgG antibody or a change from negative to positive can confirm the diagnosis.

Physical examination

1. Chest X-ray

It may manifest as increased texture in both lungs, grid-like, dot-like, and large-scale shadows. In some cases, it is more unilateral and rapidly progresses to large bilateral shadows.

2. Electrocardiogram

No specific changes. Sinus tachycardia or bradycardia and ST-T changes may be seen.

3. Magnetic resonance

The main damage is to the brainstem and gray matter of the spinal cord.

4. Electroencephalogram

Some cases may present as diffuse slow waves, and a few may present as spike (point) slow waves.