During a summer outbreak at a daycare centre, several toddlers develop low grade fever, painful oral ulcers, and tender vesicles on the palms, soles and buttocks. The most common causative agent is:

• A Varicella-zoster virus
• B Herpes simplex virus type 1
• C Coxsackievirus A16 ✓
• D Parvovirus B19

Explanation

Hand-foot-mouth disease is caused most often by coxsackievirus C16; enterovirus 71 causes similar illness but carries higher risk of neurological complications such as encephalitis and poliomyelitis-like paralysis. The distribution of oral ulcers with acral and gluteal vesicles separates it from varicella, which is centripetal and involves the scalp, and from herpangina, which causes only posterior oropharyngeal ulcers without skin lesions. Treatment is supportive.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.