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Abstract: This article is about a 3-year-old child who had a sudden onset of fever recently, and no significant abnormalities were found on examination. He recovered well after treatment.
Basic information】Male, 3 years old
Type of disease】Hand, foot and mouth disease
Hospital】Shanghai Sixth People’s Hospital
Date of consultation】March 2022
Treatment plan】Isolation + local oral spray (open-throat sword spray) + furnace glycolic lotion + heat detoxification (antiviral particles)
【Treatment period】Home observation and treatment for 7 days, outpatient follow-up after 14 days
Treatment effect] The body temperature returned to normal, the rash subsided significantly, and the symptoms improved significantly
I. Initial consultation
A child with fever came to the fever clinic in the afternoon. The child had been having fever for 3 days, and the blood test at the local hospital did not show any significant abnormality. Today, a rash appeared on the child’s body, and scattered red rashes could be seen on the palms and soles of the feet. A careful physical examination revealed that scattered red herpes could also be seen in the throat and oral mucosa. The child’s parents told him that he had gone to play in the community garden one day before the fever and had contact with other sick children, and the fever came on the second day. The blood test of this visit suggested viral infection, so the diagnosis of HFMD was considered together with the current season, contact history, blood test report and rash characteristics.
II. Treatment history
Combining the patient’s medical history and the ancillary examinations, the diagnosis of HFMD in the child was a common type of mild disease, with normal mental status, diet, and vitality in all aspects except for fever, and no complication features such as headache, jet vomiting, convulsions, or respiratory changes. HFMD is essentially a skin change caused by viral infection, which theoretically can remit on its own, but the use of some topical medications can promote the recovery of symptoms, so the child was prescribed a topical oral spray (Kai Throat Sword Spray), which acts on the herpes in the oral pharynx, together with a Chinese medicine (anti-viral granules) to clear the fever and detoxify the toxin to assist in reducing the fever, and at the same time, a furnace glycolic lotion was used to rinse the rash area to reduce the rash The child and his family were instructed to go home and isolate the rash for 7 days and come to the clinic for follow-up check-up in 2 weeks.
III. Treatment effect
The child came back to the clinic 2 weeks later, and the parents told us that the child’s temperature quickly dropped to normal in 2-3 days after the medication was administered, and his mental state and appetite were good throughout. The child’s mental outlook has also recovered, his appetite has increased, and the quality of his sleep at night has been effectively improved.
IV. Precautions
The child’s temperature returned to normal after treatment, and his condition was effectively controlled, for which we are glad, but the following points should be noted.
1, hand, foot and mouth disease is a class of infectious diseases, children need to be isolated after returning home to avoid infecting family members or other children, and pay attention to hand washing before and after meals, and good hand hygiene. And to actively brush teeth and rinse mouth to maintain oral hygiene, which is conducive to the recovery of oral herpes.
2. disinfect and clean the toys, clothes and bedding of the affected children in a timely manner, and replace them with softer bedding to reduce the stimulation of the skin.
3, to ensure air circulation at home to avoid cross-infection.
4, during the treatment period eat more high vitamin, high protein, easy to digest liquid or semi-liquid food, drink more water to avoid aggravating oral symptoms.
5.After recovery, children can take physical exercise to enhance their physical fitness and improve their ability to resist diseases in order to reduce the occurrence of such diseases.
V. Personal insight
This case reminds parents that spring is a high season for various respiratory, gastrointestinal or skin infectious diseases. Young children are more active and are in a group environment after entering kindergarten, so they are indeed vulnerable to various infectious diseases. For seasonal infectious diseases, prevention is even more significant. It is important to supervise children to do personal protection, do hand hygiene, keep their diet clean, reduce going to crowded places as much as possible if possible, and if there are other students who are sick in school, try to keep a certain distance and reduce close contact. Once the child shows symptoms, it is recommended to go to the hospital as soon as possible to confirm the diagnosis and determine whether the disease is mild or serious, so that treatment can be carried out in a timely manner to avoid delaying the disease. Parents of children with the disease also need to strengthen their understanding of various infectious diseases to avoid excessive stress when the disease appears.