Hand, Foot and Mouth Disease
- This coxsackie viral infection produces a maculopapular rash on the hands and feet, commonly affecting children below 10 years.
- Incubation period is 3-7 days
- The disease lasts for around a week to 10 days.
Early symptoms of the condition include:
- Loss of appetite.
- On examination the throat shows red spots over the throat, tonsils, mouth and tongue. These may be painful and may make swallowing difficult.
Later symptoms of the condition include:
- After the initial day or two of the infection many children develop red spots in the mouth that progress to ulcers. These worsen and are present in the mouth, tongue, tonsils, over the gums and inside the cheeks and throat. These are extremely painful and make it difficult to eat, drink or swallow.
- Nearly 75% of the infected patients develop a characteristic rash or blisters over:
- the soles of the feet
- palms of the hand
- between fingers and toes
- diaper area
These blisters are painful and may be tender if touched or pressed. They may itch initially but the rashes in most cases become non-itchy.
There’s no specific treatment for hand-foot-and-mouth disease in conventional medicine. Frequent hand-washing and avoiding close contact with people who are infected with hand-foot-and-mouth disease may help reduce risk of infection.
A Case of HMFD
A 2 year old baby girl was brought for consultation in the evening. Thechief complaint was aslight running nose. As the parents were very worried about the condition, they came for treatment before the development of symptoms.
I started exploring the case but could not get enough symptoms to prescribe,as there was only the runny nose.She was playful.Either I could prescribe something on a therapeutic basis or prescribe placebo to wait for development of the disease.I prescribed placebo instead of guessing in the dark and asked the parents to report any new symptoms.
On the morning of the third day the parents brought the baby who now had the following complaints:
Painful, red, blister-like lesions on the tongue, gums and inside the cheeks. These lesions were very painful as she was not eating anything. She had red rashes on her buttocks.These were painless and there was no itching.There were no changes in physical generals such as thirst, stool, urine, perspiration. Appetite was reduced a little bit but it may have been due to the painful blisters.
Patient was afebrile.
Mentally she was dull, not answering my questions.
After considering the whole case, the following rubrics were taken:
- Mouth, aphthae; painful
- Skin; Eruption; painless
Antim tart was the only medicine that covered both symptoms.
Rx: Antim tart 200 BD for three days was prescribed, with advice to maintain hygiene.
On the second day the patient was totally fine, eating well and had no rashes on her buttocks. The lesions were completely healed without scaring.
What I learned from this case:
- The first visit of the patient should never end in a first prescription.
- Never prescribe a remedy until you find something to prescribe on. A prescription made in haste can change the true picture of the disease.