Hand Foot Mouth (herpangina) (most commonly Coxsackievirus)
---------------------------------------------

Sx: 
-Throat Pain or refusal to eat
-Fever: low to 101F
-oral enanthem exanthem can be anywhere anterior to the faucial pillars --starts as macules, then vesicles with halo of erythema: quickly rupture
-less often but may have (fussiness, abd pain, emesis, diarrhea)
-Rash (macular papular or vesicular) may have all 3 in one patient usually on the hands/palms, feet, buttocks, legs, arms; resolves in 3-4 days

Incubation period = 3-5 days (can be up to 10)


Tx: Supportive, maintain adequate hydration (parent to monitor)

Resolution of all Sx 7-10 days 
3-4 days for herpangina

Transmission = Fecal-Oral (can pass in oral secretions also)
Virus can continue to shed in oropharynx for 1 month
Virus can continue to shed in feces for 6 wks