Approach
The illness is generally mild and self-limited, and treatment is supportive in most cases. The main goals are to relieve pain and ensure that hydration and nutrition are maintained. Resolution of lesions usually occurs within 10 days.
Supportive care
Simple oral analgesics and antipyretics such as acetaminophen and ibuprofen may be used to lower fever and relieve pain. Aspirin is not recommended for fever due to its association with Reye syndrome. Topical anesthetics (e.g., lidocaine) may also help alleviate the pain from the ulcers in the mouth. A mixture of diphenhydramine, aluminum, magnesium hydroxide, and viscous lidocaine with or without sucralfate (magic mouthwash) can be used topically for symptomatic pain control of ulcers; however, this is not a proprietary product and a pharmacist must be consulted to make up this mixture. Oral lesions may be painful and oral hydration difficult. For children with moderate-to-severe dehydration, intravenous hydration may be necessary.
Patients with immunocompromise or enterovirus 71 (EV71) infection or complications
Complications are rare. Those that can occur with EV71 infection include aseptic meningitis, encephalitis, encephalomyelitis, pulmonary edema, pulmonary hemorrhage, myocarditis, a polio-like syndrome, and death.[7][8][9][10] These patients will require hospitalization and supportive treatment for the complications. In immunocompromised patients, symptoms may be more severe and prolonged.
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