Hand, Foot, and Mouth Disease (HFMD)

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideCommon Childhood Skin Disorders

Common Childhood Skin Disorders

Why haven't we heard more about hand, foot, and mouth disease?

Recognition of hand, foot, and mouth disease is relatively recent (when contrasted with mumps, measles, and chickenpox, for example). HFMD was first reported in 1956 in Australia. By the early 1960s, it had emerged as a common childhood illness around the world.

How do health care professionals diagnose hand, foot, and mouth disease?

Usually, the diagnosis of HFMD is made on a combination of clinical history and characteristic physical findings. Laboratory confirmation is rarely necessary unless severe complications develop.

What is the treatment for hand, foot, and mouth disease?

Treatment of HFMD is directed toward symptomatic relief of fever and sore throat. Antibiotics are not indicated in the treatment of this viral disease. Intravenous immune globulin (IVIG) has been tried as a therapy for severely ill patients or immunocompromised older patients with variable success.

What are complications of hand, foot, and mouth disease?

Complications of HFMD are relatively rare. The more common cause of HFMD (Coxsackievirus A16) is less likely to cause complications when compared with enterovirus-71.

Complications include the following:

  1. "Aseptic" (also called "viral") meningitis (rare): Symptoms of meningitis are moderate-severe headache, discomfort when bending the head forward (classically tested by trying to touch the chin to the chest), and nausea and vomiting. Meningitis is an infection of the tissues and spinal fluid that surrounds the brain and the spinal cord. The diagnosis is confirmed by a lumbar puncture (also known as a "spinal tap"). Depending upon severity of the patient's symptoms, they may need to be hospitalized.
  2. Encephalitis (brain infection): Encephalitis is much less common but more ominous when compared with meningitis and requires hospitalization for close monitoring. Other rare neurologic complications include paralysis, Guillain-Barré syndrome, transverse myelitis, and cerebral ataxia. Transient and permanent impairment can both occur.
  3. Occasionally, the virus may infect the heart muscle fibers and thus compromise the heart's blood-pumping capabilities.
  4. Young infants may very rarely become dehydrated due to refusal to take oral fluids as a consequence of mouth pain.
  5. In very rare circumstances, the skin vesicles may develop a secondary bacterial infection. A short course of antibiotics are used to treat the secondary infection.
Medically Reviewed by a Doctor on 1/23/2017

Subscribe to MedicineNet's Children's Health & Parenting Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Health Solutions From Our Sponsors