Clinical characteristics and neurological manifestations of Enteroviral infection and Hand-foot-mouth disease

Abstract

            Hand-foot-mouth disease (HFMD) is a contagious and common disease in young children. Most of the infections are generally mild and self-limiting, but in some cases there are neurological complications that need specific treatment to reduce the severity of the disease. Objectives of this retrospective study was study the general information and risk factors associated with the severity in patients infected with Enterovirus and HFMD in Udonthani hospital, for benefit in monitoring and treatment to reduce severity of the disease. Data collected by retrospective review of 5 years medical records from 2015, September 1^st to 2020, September 30^th. Analyzed by descriptive and Pearson’s Chi-squared test, Fisher exact test and T-test.

            Results: 74 HFMD patients were 42 male (56.8%), mean age 23.8 months old. They were sick for 2.3 days before admission , mean body temperature at admission 37.8 °C mean highest temperature 38.4 °C. All lesions at hand, foot and mouth were found in 64 cases (86.5%). Mostly occur in rainy season, especially in June. Samples divided to 2 groups; 61 uncomplicated HFMD (82.4%) and 13 complicated HFMD (17. 6%). Complicated HFMD symptoms such as myoclonic, seizure, alteration of conscious, vomiting, highest body temperature over 39 °C and mean length of stay (LOS) were more frequency and percentage than uncomplicated HFMD with statistically significance (p<0.05). Viral isolation for Enterovirus71 (EV71) was detected in 4 complicated HFMD patients and 1 cases with Coxsackie A16. Three of five cases were treated with IVIG with gradually better until fully recovery.

            Conclusion: HFMD present with fever and lesion at hand, foot and mouth in the young children.  complicated HFMD was found 17.6%. Administrating IVIG in patient with neurological complications can reduce severity of the disease.