ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH TAY CHÂN MIỆNG NẶNG Ở TRẺ EM DƯỚI 5 TUỔI TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: To describe the clinical characteristics, paraclinical findings, and treatment outcomes of severe hand, foot and mouth disease (HFMD) in children under 5 years of age at the Vietnam National Children’s Hospital. Subjects: A retrospective case series was conducted from July 1, 2022, to June 30, 2024, involving pediatric patients diagnosed with severe hand, foot and mouth disease (HFMD) admitted to the Vietnam National Children’s Hospital. Results: A total of 113 pediatric patients were included, with a male-to-female ratio of 2.1:1. The majority (77%) were aged 12–35 months. All presented with fever; the most common clinical features were vesicular exanthema on the hands and feet and myoclonic jerks (87.6%). Less frequent symptoms included apnea, seizures, cyanosis, and hypotension. Laboratory tests revealed mildly elevated leukocyte counts on admission (mean: 13.1 ± 4.3 G/L). Enterovirus 71 (EV71) was identified in 70.9% of tested cases. EV PCR positivity was highest in stool specimens (53.3%) and throat swabs (40%; 14/35 cases). Most patients were initially classified as HFMD grade 2b, group 1 or group 2. The most frequent progression was from grade 2b group 1 to 2b group 2 (10.6%). Treatment primarily involved oral phenobarbital (95.6%), intravenous phenobarbital (14.2%), and intravenous immunoglobulin (IVIG) in 35.4% of cases. Respiratory support was required in 5.3% of patients. The overall recovery rate was 96.5%, with 3.5% experiencing neurological sequelae, including flaccid paralysis and limb weakness. No mortality was reported. Conclusion: Hand, foot and mouth disease were mostly found in males. The main clinical symptoms are fever, blisters on hands and feet and convulsions. The rate of PCR EV 71(+) was high in stool and throat samples. Early detection, diagnosis and treatment intervention reduce complications and mortality rates of hand, foot and mouth disease in children, limiting sequelae that affect quality of life.