In young infants, these lesions also may be observed on the trunk, thighs, and buttocks. The enteroviruses, specifically coxsackievirus A16, predominate. Laboratory studies usually are unnecessary. If clinical circumstances dictate, the virus can be recovered from the HFM lesions. Typically, the virus can be grown in culture or confirmed by immunologic methods.
Treatment is primarily supportive.
It is extremely important to examine the patient's hydration status by evaluation and documentation of lacrimation, mucosal membranes, skin turgor, urine output, and pulse or capillary refill time. Antipyretics should be given as needed for fever. IV hydration should be given if the clinical assessment indicates. Antibiotics are not indicated unless a complicating secondary skin infection is present. A secondary skin infection is the main complication.