Hand, Foot and Mouth Disease
Francesca Longobardo
Western University of Health Sciences
Senior Seminar
Mr. Medina
November 24, 2014
Student Name: Francesca Longobardo PA-S Date & time of Interview: 11/7/2014 10:40
PATIENT WRITE-UP/SOAP NOTE PRESENTATION
SUBJECTIVE DATA:
Identifying data (ID): 1 y/o male, Hispanic
Chief Complaint (CC): rash x 3days
History of Present Illness (HPI): The child’s mother reports that a rash started under the buttocks, the rash was erythematous and vesiculated. The rash had spread to the palms of his hands and soles of his feet. The vesicles and ulcers were also located on the buccal mucosa. Very happy and non-distressed child. He had no other associated symptoms, he was able to eat and drink.
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This little boy eventually developed paroxysmal supraventricular tachycardia. The precipitating events of PSVT are not easily identified; it can be caused by rapidly progressing fever. A current theory on the link between cardiac arrhythmias and Hand, Foot and mouth disease is that the invasion or enterovirus 71 into the myocardial cells creates the cardiac arrhythmia. This invasion causes a triggering of the inflammatory cascade with lymphocytes and eventually causes myocardial necrosis. The symptoms can takes months to resolve (Paroxysmal Supraventricular Tachycardia in an Infant with Hand, Foot, and Mouth Disease, …show more content…
This is usually a clinical diagnosis, but can be determined by viral polymerase chain reaction and ELISA analysis. The best place to culture for viral polymerase chain reaction is the throat. Clinical presentation tends to be a child with fever and ulcerated rashes that can affect the palms of the hands and soles of the feet. There are no diagnostic imaging studies that can help determine infection. The disease is usually treated symptomatically by reducing the fever and introducing fluids to help with dehydration and making sure the patients intakes proper nutrients. With proper symptomatic treatment the patient can greatly diminish the severity and enhance the prognosis of the disease.
References
Lin, J.Y., & Shih, S.R. (2014). Cell and tissue tropism of enterovirus 71 and other enteroviruses infections. Journal of Biomedical Science, 21(18), 1-6.
Repass, G.L., Palmer, W.C., & Stancampiano, F.F. (2014). Hand, foot, and mouth disease:
Identifying and managing an acute viral syndrome. Cleveland Clinic Journal Of Medicine, 81 (9), 537-543.
Hu, P., Hou, S., Du, P.F., Li, J.B., & Ye, Y. (2012). Paroxysmal Supraventricular Tachycardia in an Infant with Hand, Foot, and Mouth Disease. Annals of Dermatology 24( 2), 200-202
Tan, C. H., Lai, J.K.F., Sam, I.C., & Chan, Y.F. (2014), Recent developments in antiviral agents against enterovirus 71 infection,
If an adult develops hand, foot and mouth disease, their symptoms will usually be much milder compared with those of a child.
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Harley, D, Sleigh, A & and Ritchie, S 2011, ‘Ross river virus transmission, infection, and disease: a cross-disciplinary review’, Clinical Microbiology Reviews, vol. 14, no. 4, pp. 909-932, doi:10.1128/CMR.14.4.909-932.2001
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