Coxsackie virus

==Background== [1]

  • Spread via the fecal-oral route
  • Most common in the summer and fall

Background

Differential Diagnosis

Pediatric Rash

Vesiculobullous rashes

Febrile

Afebrile

Evaluation

  • Clinical diagnosis, based on history and physical examination

Management

  • No specific therapy for most; self-limited
  • NSAIDS and cool liquids for pain
  • Encourage good hand hygiene to prevent spread
  • Some recommend Magic Mouthwash/oral lidocaine if not tolerating PO intake, although evidence suggests no better than placebo[3]

In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning[4][5]

Disposition

  • Discharge with close outpatient followup to ensure adequate PO intake.

See Also

External Links

References

  1. Sobolewski B, Mittiga MR, Gonzalez del Rey JA. Pediatric conditions. In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. The Atlas of Emergency Medicine. 4th ed. New York, NY: McGraw-Hill; 2016:(Ch) 14.
  2. Sobolewski B, Mittiga MR, Gonzalez del Rey JA. Pediatric conditions. In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. The Atlas of Emergency Medicine. 4th ed. New York, NY: McGraw-Hill; 2016:(Ch) 14.
  3. Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9
  4. FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm
  5. Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39