Painful miliary to blisters on the tongue and gums
Introduction
Introduction Hand, foot and mouth disease incubation period of 3 to 5 days, there are low fever, general malaise, abdominal pain and other prodromal. In 1 to 2 days, painful miliary to mung bean-sized blisters appear in the mouth, throat, soft palate, buccal mucosa, tongue, and gums. The circumference is surrounded by redness, which is broken into small ulcers. Because of pain, it often flows and refuses to eat. Hand, foot and mouth disease mainly occurs in children under 4 years of age, but adults may also get sick, so it can be said that everyone is susceptible. After infection, only the immunity of this type of virus is obtained, and there is no cross-immunization for reinfection of other types of viruses. That is, after suffering from hand, foot and mouth disease, it may also suffer from hand, foot and mouth disease again due to infection with other types of viruses.
Cause
Cause
(1) Causes of the disease
There are several viruses that can cause hand, foot and mouth disease. The most common type is Coxsackievirus A16, and other strains of Coxsackievirus A or enterovirus 71 can also cause hand, foot and mouth disease. Coxsackie virus is a type of enterovirus. Enteroviruses include poliovirus, coxsackie virus and echovirus. The infected part is the entire digestive tract including the oral cavity, and enters the body through contaminated food, drink, fruit, etc., and proliferates in the intestine.
(two) pathogenesis
The foot-and-mouth disease virus belongs to the family of picornaviruses and is now known as aphoviruses. It is a spherical particle with a diameter of 22-30 nm and has 7 different serotypes: A, O, C, SATI, SATZ, SAT3 and Asia-1. There are at least 63 subtypes. The type distribution of each epidemic area is different, and there is no cross-immunization between the various types. Almost all of the human beings are isolated from the O type, and occasionally the C type. The source of infection is an animal suffering from foot-and-mouth disease. The blood, skin mucosal secretions, saliva, urine, feces, and milk of diseased animals carry viruses. Mostly, when it comes into direct contact with a diseased animal or milking, the virus enters the human body through tiny skin wounds, and can even be infected by eating infected milk, cheese, butter or other dairy products, and even eating the meat of sick cows. And bones can also be infected. It is difficult for people to infect each other.
Examine
an examination
Related inspection
Blood routine oral X-ray examination oral endoscope
The incubation period is 3 to 5 days, and there are prodromal symptoms such as low fever, general malaise, and abdominal pain. In 1 to 2 days, painful miliary to mung bean-sized blisters appear in the mouth, throat, soft palate, buccal mucosa, tongue, and gums. The circumference is surrounded by redness, which is broken into small ulcers. Because of pain, it often flows and refuses to eat. At the same time, there are also rashes on the hands and feet. On the back side of the hands and feet and the back side of the fingers (toes), around the nails, and in the palmar stalks, there are a number of blisterings. In addition to the hands and feet, they can also be seen near the buttocks and anus, even in the trunk and Limbs, dry and regress after a few days, no pruritus, no pain. Individual children may have generalized papules, blisters, aseptic meningitis, encephalitis, myocarditis, etc. Generally good, the whole course of disease is about 5 to 10 days, most of them can be self-healing, and the prognosis is good.
Diagnosis
Differential diagnosis
Foot and mouth disease should be differentiated from foot and mouth disease.
First, the pathogen is different: the pathogen of foot-and-mouth disease is foot-and-mouth disease virus, which belongs to the zoonotic pathogen. Hand, foot and mouth disease is caused by several enterovirus infections.
Second, the source of infection is different: Foot-and-mouth disease virus only causes the foot-and-mouth disease of animals, cattle, sheep, pigs, deer, camels, etc., which are the source of infection of foot-and-mouth disease. Only when the animal epidemic first appears can it cause illness. The source of infection of hand, foot and mouth disease is the person carrying the virus in the patient and the intestine, and belongs to human diseases.
Third, the transmission route is different: foot-and-mouth disease is infected by the skin and mucous membranes by contact with the ulcers of the oral cavity and hoof of the diseased animal; occasionally, it is infected with milk infected by the virus and not heated (pasteurized). Therefore, people suffering from foot-and-mouth disease are extremely scattered. Hand, foot and mouth disease is caused by contact with patients through the pollution of daily necessities, utensils, toys, and can also be transmitted through the respiratory tract. Therefore, there are different scales of popularity.
