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作者:医度网 来源:医度网 日期:2019-06-12 06:12:00

        初夏已至,气温逐渐攀升,手足口病和疱疹性咽峡炎正悄然增多。这两种疾病都是由多种常见的肠道病毒引起的传染性疾病,多发生于5岁以下的婴幼儿和学龄前儿童。手足口病有很强的传染性,一年四季都可发生,但常见于夏秋季。据统计, 目前有二十多种的肠道病毒可引起手足口病和疱疹性咽颊炎,其中最常见的是柯萨奇病毒A型中的各类亚型。

Summer is coming and the temperature is expected to rise gradually. There is an increased incidence of hand, foot and mouth disease (HFMD) and Herpangina. These are two common viral illnesses that mainly affect infants and young children below five years of age. Both of them are contagious and easily spread from one person to another. HFMD and Herpangina can present throughout the year, but usually occur during the summer and fall months in China. They are both caused by about 20 serotypes of the Enterovirus A but particularly the various strains of Coxsackievirus A.

1. 手足口病和疱疹性咽颊炎分别有什么表现呢?

手足口病

手足口病的症状一般出现于感染病毒3天到7天后,一周左右自愈, 一般不超过10天。发病早期的表现类似普通的感冒,食欲减退,口腔或咽喉疼痛,浑身不适,有时候可能会伴有发热。

典型的手足口病一般在起病或发烧1到2天后,口腔颊粘膜,舌,或咽喉部会出现小而扁平的红色斑点,并且逐渐发展为小疱疹, 然后破溃形成疼痛的小溃疡。患儿常因嘴里的溃疡疼痛而不愿进食和喝水,小年龄的孩子会有流口水比平时增多。同时手心和脚底会有这些扁平的小红点,有时还会出现在膝盖,肘关节,臀部和肛门周围, 这些皮疹也会发展成小疱疹, 周围有红晕。手足口病的皮疹另一个特点是不会发痒。大多数患儿在一周内体温下降,皮疹逐渐消退, 疱疹也在逐渐干燥结痂,脱痂后不留疤痕。

近年来发现的柯萨奇病毒A6和A10型,可能会伴有比较明显的发热,累及多处和较多的皮疹,除了手,足,口外,还会发生于四肢,面部,口唇,腹股沟,臀部,和会阴区域,还会出现多种皮肤受损,比如水疱大疱性皮损,糜烂,溃疡和焦痂。持续时间会长至1-2周左右。另外,有时候会在手足口病1-3周后出现手心足底皮肤脱屑,1-2月发生指趾甲营养不良或脱落等。

疱疹性咽颊炎

疱疹性咽峡炎一般出现于感染病毒3天到7天后,通常会有发热。因为口腔内有疱疹的关系,会有咽痛和吞咽困难。在小年龄婴幼儿中,常会出现流口水,拒食,呕吐,烦躁不安等情况。疱疹一般出现在口腔的后半部分,比如软腭,腭舌弓,咽峡部,悬雍垂等。先表现为红色的小红点,然后生成周围有红晕的小水疱,之后破溃成边缘发红的小溃疡。但和手足口病不同的是,疱疹和红色皮疹不会出现在口腔粘膜以外的身体皮肤上。

需要注意的是,不是所有感染了这些肠道病毒的人都会有以上所有症状,有些人感染了病毒或许一点症状都没有,却仍可能传染病毒给其他人,就是我们平时说的无症状带毒者或隐性感染者,多见于成人。

1.What Are the Symptoms of HFMD and Herpangina?

HFMD

HFMD usually start 3 to 7 days after catching the infection and it can last from 7 to 10 days. Symptoms usually begin with a common cold, poor appetite, sore throat, a feeling of being unwell, and sometimes may accompany with fever.

A day or two after the fever starts, red spots can develop in the mouth, buccal mucosa, tongue, or throat which may turn to blisters and then ulcers. Since the mouth sores area quite painful, some young children may drooling more his usual and may not be able to swallowing enough liquid, thus might have the risk of dehydration. Small skin rash with flat red spots may also develop on the palms of the hands and soles of the feet. Sometimes a rash also occurs on the knees, elbows, buttocks and nappy area. This rash may also become blisters or bumps with erythema surroundings but won't itch. Symptoms and signs mostly typically resolved within 7 to 10 days with fever subsided, rash faded, and blister dry and crusted.

It has been reported in recent years that Coxsackievirus A6 and A10 HFMD may have higher fever and wider distribution of skin lesions. Apart from hand, foot and mouth, skin rash may involve the arms, legs, face, lips and perioral area, buttocks, groin, and perineum. Skin lesion may be presented as vesiculobullous lesions, bullae, erosions, ulcerations, and eschar formation. The condition may persist as long as one to two weeks. In addition, sometimes palmar and plantar desquamation, nail dystrophy may occur 1 to 3 weeks and 1 to 2 months after HFMD.

Herpangina

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