Hand-foot-and-mouth disease differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hand-foot-and-mouth disease}} | {{Hand-foot-and-mouth disease}} | ||
{{CMG}} {{AE}} {{AN}} | {{CMG}} {{AE}} {{AN}}; {{YK}} | ||
==Overview== | ==Overview== | ||
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! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Presentation}} | ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Presentation}} | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''Herpes simplex virus''' | | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Herpes simplex virus stomatitis]]''' | ||
| style="background: #DCDCDC; padding: 5px;" | [[ | | style="background: #DCDCDC; padding: 5px;" | • Associated with high grade [[fever]], acute [[gingivitis]] and oral ulcerations <br>• The vesicles are small, grouped together and on an erythematous base<br>• Absence of [[rash]] on palms and soles<br>• A [[Tzanck test]] shows multinucleated giant cells and direct fluorescent antigens test can also help to differentiate hand-foot-and-mouth disease from [[herpes simplex virus]] infection | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''' | | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Herpangina]]''' | ||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | | style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''' | | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Bacteremia]] and [[sepsis]]''' | ||
| style="background: #DCDCDC; padding: 5px;" | [[Leucocytosis]] <nowiki>>15,000 cells/mL OR serum creatinene level >1.5</nowiki> times baseline or abdominal tenderness and serum albumin < 3 g/dL | | style="background: #DCDCDC; padding: 5px;" | [[Leucocytosis]] <nowiki>>15,000 cells/mL OR serum creatinene level >1.5</nowiki> times baseline or abdominal tenderness and serum albumin < 3 g/dL | ||
|- | |- | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''' | | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Chickenpox]]''' | ||
| style="background: #DCDCDC; padding: 5px;" | [[Hypotension]] or [[shock]], [[ileus]], [[megacolon]], [[leucocytosis]] >20,000 cells/mL OR [[leucopenia]] <nowiki><2,000, lactate ></nowiki>2.2 mmol/L, [[delirium]], [[fever]] ≥ 38.5 °C, organ failure | | style="background: #DCDCDC; padding: 5px;" | [[Hypotension]] or [[shock]], [[ileus]], [[megacolon]], [[leucocytosis]] >20,000 cells/mL OR [[leucopenia]] <nowiki><2,000, lactate ></nowiki>2.2 mmol/L, [[delirium]], [[fever]] ≥ 38.5 °C, organ failure | ||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Measles]]''' | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Pharyngitis]]''' | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Stevens-Johnson syndrome]]'''<br> or [[Erythema multiforme]] | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Henoch-Schönlein purpura]]''' | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Kawasaki disease]]''' | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Behcet's disease]]''' | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
|- | |||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Pemphigus vulgaris]]''' | |||
| style="background: #DCDCDC; padding: 5px;" | Raised white cell count but <15,000 cells/mL and serum creatine <nowiki><1.5 times baseline</nowiki> | |||
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** The [[ulcer]]s are on the mucosal surface of the mouth and is not associated with [[fever]], [[malaise]] or [[rash]]. | ** The [[ulcer]]s are on the mucosal surface of the mouth and is not associated with [[fever]], [[malaise]] or [[rash]]. | ||
* [[Stevens-Johnson syndrome]]/ [[Erythema multiforme]] | * [[Stevens-Johnson syndrome]]/ [[Erythema multiforme]] | ||
* [[Henoch-Schönlein purpura]] | * [[Henoch-Schönlein purpura]] | ||
* [[Kawasaki disease]] | * [[Kawasaki disease]] |
Revision as of 20:49, 24 October 2016
Hand-foot-and-mouth disease Microchapters |
Differentiating Hand-foot-and-mouth disease from other Diseases |
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Diagnosis |
Treatment |
Treatment |
Hand-foot-and-mouth disease differential diagnosis On the Web |
American Roentgen Ray Society Images of Hand-foot-and-mouth disease differential diagnosis |
Hand-foot-and-mouth disease differential diagnosis in the news |
Directions to Hospitals Treating Hand-foot-and-mouth disease |
Risk calculators and risk factors for Hand-foot-and-mouth disease differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]; Yamuna Kondapally, M.B.B.S[3]
Overview
Hand-foot-and-mouth disease should be differentiated from other conditions that cause maculopapular or vesicular rash which includes herpes simplex virus infections, herpangina, chicken pox and measles.
Differentiating Hand-foot-and-mouth disease from other Diseases
Hand-foot-and-mouth disease should be differentiated from other conditions that cause maculopapular or vesicular rash include:
Infection | Presentation |
---|---|
Herpes simplex virus stomatitis | • Associated with high grade fever, acute gingivitis and oral ulcerations • The vesicles are small, grouped together and on an erythematous base • Absence of rash on palms and soles • A Tzanck test shows multinucleated giant cells and direct fluorescent antigens test can also help to differentiate hand-foot-and-mouth disease from herpes simplex virus infection |
Herpangina | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Bacteremia and sepsis | Leucocytosis >15,000 cells/mL OR serum creatinene level >1.5 times baseline or abdominal tenderness and serum albumin < 3 g/dL |
Chickenpox | Hypotension or shock, ileus, megacolon, leucocytosis >20,000 cells/mL OR leucopenia <2,000, lactate >2.2 mmol/L, delirium, fever ≥ 38.5 °C, organ failure |
Measles | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Pharyngitis | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Stevens-Johnson syndrome or Erythema multiforme |
Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Henoch-Schönlein purpura | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Kawasaki disease | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Behcet's disease | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
Pemphigus vulgaris | Raised white cell count but <15,000 cells/mL and serum creatine <1.5 times baseline |
- Herpes simplex virus infections
- Herpes stomatitis
- Associated with high grade fever, acute gingivitis and oral ulcerations.
- The vesicles are small, grouped together and on an erythematous base.
- Absence of rash on palms and soles.
- A Tzanck test shows multinucleated giant cells and direct fluorescent antigens test can also help to differentiate hand-foot-and-mouth disease from herpes simplex virus infection.
- Herpes stomatitis
- Herpangina
- Bacteremia and Sepsis
- Chicken pox
- Measles
- Pharyngitis
- Aphthous ulcers/ Gingivitis
- Stevens-Johnson syndrome/ Erythema multiforme
- Henoch-Schönlein purpura
- Kawasaki disease
- Other rare conditions in children: