Coxsackievirus is a common viral infection, primarily affecting infants and young children, though it can occur at any age. It is a primary cause of hand, foot, and mouth disease (HFMD), known for its characteristic skin lesions. Coxsackieviruses are part of the enterovirus family, which reside in the human digestive tract. While typically mild, the infection presents with distinct rashes and blisters.
Recognizing Common Skin Manifestations
The skin manifestations of coxsackievirus, particularly in hand, foot, and mouth disease, appear as a rash of flat, discolored spots that evolve into blisters. These lesions begin as small, red macules (1-2 mm), then develop into oval-shaped vesicles (2-10 mm) with a reddish base, often on the palms and soles of the feet. The blisters are often elongated rather than round and contain clear fluid.
Beyond the hands and feet, these lesions commonly appear in and around the mouth, including the lips, tongue, gums, and the back of the throat. These oral sores, known as mouth ulcers, can measure 2-3 mm and rupture quickly, causing pain and making eating and drinking difficult. The rash can also extend to other areas, such as the buttocks (especially in infants), knees, elbows, or genital area.
While the rash is rarely itchy for children, adults can experience significant itching. These skin lesions generally resolve within 7 to 10 days.
Accompanying Symptoms
Before the distinctive rash and blisters appear, individuals with coxsackievirus infection experience flu-like symptoms. These initial symptoms typically manifest one to two days before the rash becomes visible. Common accompanying symptoms include a fever (which can be low-grade or high) and a general feeling of being unwell.
A sore throat and a runny nose are also frequently reported. Children may also experience a decreased appetite, vomiting, or diarrhea. In some cases, children might simply feel warm without exhibiting other specific symptoms. These preliminary symptoms usually last one to two days before the characteristic rash and mouth sores develop.
When to Consult a Doctor
While coxsackievirus infections are often mild and resolve without specific treatment, medical consultation is advisable in certain situations. Consult a doctor if a fever persists for more than three days, particularly if it is above 39°C in children under three years old, as this could indicate a higher risk of complications. Signs of dehydration, such as decreased urination, dry mouth, or difficulty drinking fluids due to painful mouth sores, warrant medical attention.
Seek professional advice if symptoms worsen after 7-10 days or do not improve within this timeframe. Concerns about severe symptoms like a stiff neck, severe headache, confusion, unusual sleepiness, or sensitivity to bright light, could point to more serious conditions like meningitis or encephalitis. Difficulty breathing or chest pain also requires immediate medical assessment. For infants under six months or any child with a weakened immune system, consult a doctor even for seemingly mild symptoms.