Rare type of hand, foot and mouth disease
Posted on October 15, 2009Filed Under Hand-Foot-Mouth Disease Symptoms | Leave a Comment
Continuing high incidence of hand, foot and mouth disease, more and more people come to realize in this disease. However, there are many rare and severe clinical forms of hand, foot and mouth disease is not only the common people do not understand is that some medical staff are not very clear.
Hand, Foot and mouth disease mainly by the Coxsackie virus A16 and enterovirus type 71 caused by an acute infectious disease, 79% of children infected with fever, hand, foot and mouth herpes appears small, for mild patients. Although only a handful of cases of severe disease, but its heavier rare complications and clinical manifestations, especially the individual infected with flac, foot, oral herpes, or herpes does not appear very little, only to show damage to other systems of children, vulnerable to misdiagnosed, delaying treatment. Popular in recent years, more serious caused by enterovirus 71, and specific clinical manifestations of severe cases of more, expressed as viral meningitis, encephalitis, myelitis, pulmonary edema, pulmonary hemorrhage and myocarditis. Therefore, we should be wary of hand, foot and mouth disease a rare and severe clinical forms in order to reduce the misdiagnosis rate of disease and mortality.
Type 1: Viral meningitis and encephalitis
Caused by enterovirus 71 viral meningitis and encephalitis varying severity, clinical manifestations were fever, headache, common, followed by the hand, foot and mouth herpes occur. And some children who have no herpes, only to show symptoms of encephalitis. Symptoms of encephalitis, often after the rash appears 2 to 4 days, expressed as convulsions or tremors, vomiting, sleep disorders, nystagmus, reflex abnormalities and meningeal irritation-positive. In August 2000, Shandong province, a 3-year-old children in a sudden fever, body temperature as high as 39 ℃ and above, hand, foot and mouth appears a small amount of herpes, two days after the convulsions, vomiting, neck stiffness, after lumbar puncture examination, diagnosed as having viral meningitis. The clinical manifestations of encephalitis are often more important than meningitis, mortality high, and side effects may also be recovered later.
Type 2: poliomyelitis-like polio
Hand, Foot and mouth disease may be complicated by a similar kind of paralysis of polio, also known as type polio, limb muscle relaxation showed weakness, flaccid paralysis, unable to walk. In severe cases, paralysis can occur throat, causing difficulty in swallowing and choking; or respiratory muscle paralysis, causing difficulty in breathing. This kind of paralysis as the main performance of hand, foot and mouth disease is not uncommon.
As the hand, foot and mouth disease, mostly infants and young children do not walk, their symptoms may not be paralyzed attention. Therefore, we must guard against the performance of class of polio incidence of hand, foot and mouth disease.
Type 3: Myocarditis and heart failure
Hand, Foot and mouth disease in the performance of the severity of myocardial injury complicated mixed, mainly pale, breathing difficulties, loss of appetite, poor feeding and so on, older children initiate a private prosecution precordial discomfort, palpitation, suffocation, dizziness and so on. Increased heart rate, body check can be found quickly, the first heart sound less blunt, gallop rhythm, arrhythmia, or bradycardia, severe heart failure and those who may be manifested as cardiogenic shock, ECG and myocardial enzyme test can be found nothing unusual. Shandong Province in 2003 in a hospital reported 48 cases of hand, foot and mouth disease complicated by myocarditis, of which 2 cases died of heart failure. Doctors in the summary of these cases found that hand, foot and mouth disease occurred as high as 46.3% of myocardial impairment, age, the smaller the longer the fever, rash subsided the longer the greater the proportion of myocardial damage.
Type IV: pulmonary edema and pulmonary hemorrhage
In 1995, the United States a 3-year-old girl suffering from hand, foot and mouth disease, two days after the sudden death of tachycardia and difficulty breathing. The girl became the first cases of hand, foot and mouth disease case report with pulmonary damage. Hand, Foot and mouth disease the symptoms of lung damage originating at the onset of the first 1 to 3 days, clinical manifestations of sudden tachycardia, dyspnea, cyanosis, cough pink bubble of phlegm, severe shock. In 1998 Taiwan’s most serious one hand, foot and mouth disease epidemic, 405 people with severe, 78 people were killed, and 80% died of pulmonary edema and pulmonary hemorrhage. Pulmonary edema and pulmonary hemorrhage hand, foot and mouth disease is the most serious complications, 90% of cases in the event of pulmonary edema within 12 hours after death.
Although the hand, foot and mouth disease a rare and severe clinical forms of only a few thousandths, but the disease is easily spread, often in children’s nurseries in concentration caused a pandemic, can jeopardize the lives of some infants and young children. If parents find child has high fever subsided, coughing, shortness of breath, looking pale and apathetic, limb weakness and other symptoms, should be wary of the child occurred encephalitis, polio type, pulmonary edema, and myocarditis may be a timely manner to the designated hospital.
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