An outbreak occurs in a playgroup: several children develop low-grade fever, mouth ulcers on the buccal mucosa and tongue, followed by vesicles on the palms, soles, and buttocks. The vesicles are elliptical with surrounding erythema. What is the causative organism?
- A Herpes simplex virus type 1
- B Varicella-zoster virus
- C Coxsackievirus A16 ✓
- D Parvovirus B19
Correct answer: C. Coxsackievirus A16
Explanation
Hand, foot and mouth disease is caused most commonly by Coxsackievirus C16, and increasingly by enterovirus 71 in Asia, which carries a higher risk of neurological complications. The combination of oral enanthem plus acral and buttock vesicles distinguishes it from varicella, which crops lesions on the trunk centrally, and from herpes gingivostomatosis, which lacks the acral eruption. Parvovirus causes slapped-cheek erythema infectiosum, not vesicles.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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