Case history
Case history
A 5-year-old boy presents with a 3-day history of malaise and a mild fever. In the last 24 hours he has complained of a sore mouth and developed vesicles on his hands and feet. He has been well until this illness, and there are no other symptoms. All other family members are well. On examination, he has a temperature of 37.6°C (99.6°F) and several small oral ulcers and small oval vesicles with an erythematous base on the palms.
Other presentations
May also present with oral lesions only and without any fever. Other symptoms can include abdominal pain and diarrhoea, upper respiratory symptoms such as a sore throat and cough, headache, loss of appetite, arthralgias, and irritability.
In East and South-east Asian countries, such as Taiwan and Malaysia, enterovirus 71 (EV71) has caused a more severe illness with complications that include aseptic meningitis, encephalitis, encephalomyelitis, pulmonary oedema, pulmonary haemorrhage, myocarditis, and a polio-like syndrome. Death occurs in some of these patients (8% in one outbreak).[11][5][7][8][9][10] Patients may present with symptoms of these complications, but infection with EV71 is uncommon in the US and Europe.
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