Clinical Characteristics Study Of 2125 Cases Of Hand Foot Mouth Disease

Objectives To analyzed the clinical characteristics of hand foot and mouth disease(HFMD)in 2,125 children in order to providing reference basis for clinical diagnosis and treatment of HFMD.Method A total of 2,000 cases of severe HFMD and 125 cases of common HFMD in 6 tertiary hospitals and 3 secondary hospitals in Guangxi Zhuang Autonomous Region were collected,with their clinical data analyzed and their clinical features compared.Results 1.The age of children with HFMD ranged from 1 to 4 years,with the median age 2.38 years,and the average age 1.86 ±1.07 years.There were1,722 cases with severe HFMD and while 278 cases belong to were critical group.2.HFMD children with fever was 90.40%,among them,the fever rate of HFMD in severe cases was 100.00%.All HFMD patients presented with rashes,which were manifested as maculopapules and herpes.Oral mucosal herpes was the most common type.3.Symptoms and signs of nervous system in children with severe HFMD: it was commonly featured by listlessness,vomiting,some unconscious abnormalities and disturbance of consciousness;the clinical manifestations of brainstem injury were 59.40% of them with limb tremor,1.40% of them with nystagmus or dyskinesia of the eyes,pupil unequal circle,large or enlarged occupied 4.90%,and 3.25% of them with dull or disappeared pupilary light reflex.4.The neurological symptoms of children with critically severe HFMD were mainly lethargy or coma.Respiratory involvement was manifested by rapid breathing,irregular respiratory rhythm or slow breathing with 2.15% of them having cough pink foam sputum or hemoptysis,and 5.65%of them demonstrating central respiratory failure.Cardiovascular system was shown as faster heart rate,pale and grey complexion,cyanosis of the mouth and fingers,skin pattern and cold limbs.1.40% of them had severe hypertension,4.00% of them showed of continuous decrease of persistent hypotension,and4.00% of them suffered from shock.5.In the cases of severe HFMD,the etiological nucleic acid detection of throat swabs was positive,constituting67.27% of 987 cases.In 664 cases of etiological nucleic acid detection of throat swabs with positive result,EV71 accounted for 78.70%,CoxA 16 7.40%,and other enteroviruses 14.01%.In 356 cases of the etiological nucleic acid detection of cerebrospinal fluid,EV71 made up 18.70%,CoxA16 1.50%,and other enteroviruses 23.50%.6.The increase of WBC value in peripheral blood of chilren in severe HFMD group accounted for 72.80%,and the increase of blood sugar over 8.3 mmol/L made up 17.80%.Conclusion 1.HFMD in children is more common in early childhood with the typical clinical manifestations as having fever and rash,among which oral mucosal herpes is the most common.2.The nervous system injury of children with severe HFMD is characterized by persistent high fever,listlessness,vomiting,limb shaking and with respiratory and circulatory system damage as the severe one.3.EV71 virus is the most common etiology in children with severe HFMD.Pathogenic positive results are found in throat swabs and cerebrospinal fluid also.4.Close attention to clinical features is helpful for early identification of severe HFMD.