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Xing-Wang Li Xin Ni Su-Yun Qian Quan Wang Rong-Meng Jiang Wen-Bo Xu Yu-Cai Zhang Guang-Jun Yu Qiang Chen Yun-Xiao Shang Cheng-Song Zhao Hui Yu Ting Zhang Gang Liu Hui-Ling Deng Jie Gao Xian-Gui Ran Qiao-Zhi Yang Bian-Li Xu Xue-Yong Huang Xing-Dong Wu Yi-Xiao Bao Yi-Ping Chen Zhi-Hai Chen Qing-Quan Liu Guo-Ping Lu Chun-Feng Liu Rong-Bing Wang Guo-Liang Zhang Fang Gu Hong-Mei Xu Ying Li Tao Yang 《World journal of pediatrics : WJP》2018,14(5):437-447
Background
Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed.Methods
National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD.Results
Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases.Conclusion
The guidelines can provide systematic guidance on the diagnosis and management of HFMD.
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