A 4-year-old boy is brought to the emergency department for evaluation of a fever for 1 day. The mother reports that he has had severe pain in his lower extremities and difficulty eating since yesterday. He has not had a cough, nausea, or vomiting. He was born at term and has been healthy. His immunizations are up-to-date. He appears irritable. His temperature is 38.5°C (101.3°F). Examination shows several flesh-colored, tender papules over the trunk, knees, palms, and soles. There are multiple 2-mm, reddish macules on the hard palate. The remainder of the examination shows no abnormalities. The infectious agent most likely responsible for this patient's current condition is also associated with which of the following?

Question

Quizplus · Accepted Answer

Eductional Objective: Hand-foot-and-mouth disease (oral ulceration and extremity rash) and herpangina (oral ulcerations without rash) are the most common manifestations of enteroviral infection.  Rare but serious complications of infection include myocarditis and central nervous system disease (eg, aseptic meningitis).

A 4-Year-Old Boy Is Brought to the Emergency Department for Evaluation