A Case of Atypical Hand-Foot-and-Mouth Disease Caused by Coxsackievirus A6: Differential Diagnosis from Varicella in a Pediatric Intensive Care Unit

• Published in: Japanese Journal of Infectious Diseases Vol. 66; no. 6; pp. 564 - 566
• Main Authors: Yasui, Yoshinori, Makino, Tomohiko, Hanaoka, Nozomu, Owa, Kenji, Horikoshi, Atsuko, Tanaka, Atsuo, Suehiro, Yutaka, Shimizu, Hiroyuki, Kanou, Kazuhiko, Kobayashi, Masaaki, Konagaya, Masami, Fujimoto, Tsuguto
• Format: Journal Article
• Language: English
• Published: Japan National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee 2013
• Subjects: Chickenpox - diagnosis; Chickenpox - pathology; Chickenpox - virology; Child, Preschool; Coxsackievirus; Diagnosis, Differential; Enterovirus - classification; Enterovirus - genetics; Enterovirus - isolation & purification; Female; Hand, Foot and Mouth Disease - diagnosis; Hand, Foot and Mouth Disease - pathology; Hand, Foot and Mouth Disease - virology; hand-foot-and-mouth disease; Humans; infection control; Intensive Care Units, Pediatric; PCR; varicella
• ISSN: 1344-6304; 1884-2836
• DOI: 10.7883/yoken.66.564

In 2011, a large outbreak of hand-foot-and-mouth disease (HFMD) caused by coxsackievirus A6 (CV-A6) occurred in Japan and other countries. The cutaneous manifestations of CV-A6-associated HFMD (CV-A6-HFMD) are more extensive and variable than those of classic HFMD (1-3). Differential diagnosis of HFMD from chickenpox is occasionally challenging because of its unusual clinical characteristics. For example, the spread of rashes in CV-A6-HFMD is more toward the extremities and body trunk, a manner different from that in typical HFMD in which the rashes are mostly localized to the hands and soles of the feet (1,2).