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Kinder- und Jugendmedizin 2017; 17(04): 259-263
DOI: 10.1055/s-0038-1629427
Infektionskrankheiten und Impfprävention
Schattauer GmbH

Coxsackievirus-A6-assoziierte Hand-Fuß-Mund-Krankheit

Fallbericht und Zusammenfassung bisheriger LiteraturCoxsackievirus A6 associated hand-foot-and-mouth diseaseCase report and summary of existing studies
K. Rieger
1   Universitätsklinik und Poliklinik für Kinder und Jugendliche Leipzig
,
V. Schuster
1   Universitätsklinik und Poliklinik für Kinder und Jugendliche Leipzig
,
U. G. Liebert
2   Universitätsklinik Leipzig, Institut für Virologie
› Institutsangaben
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Publikationsverlauf

Eingereicht am: 26. März 2017

angenommen am: 05. April 2017

Publikationsdatum:
24. Januar 2018 (online)

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Zusammenfassung

Die Hand-Fuß-Mund-Krankheit (HFMK) ist ein gut bekanntes pädiatrisches Krankheitsbild. Zunehmend wird vor allem aus dem asiatischen und amerikanischen Raum von Coxsackievirus A6 (CVA6)-assoziierten Erscheinungsbildern berichtet. Die besondere Herausforderung hierbei stellt die Abgrenzung zu oftmals ähnlich imponierenden mitunter gefährlichen Krankheitsbildern, wie Herpesvirus- oder Staphylokokken-Superinfektionen, dar. Das CVA6-assoziierte Erscheinungsbild ist in dieser Arbeit anhand eines Fallbeispiels und einer Zusammenfassung literaturbekannter Daten beschrieben. Es ist klinisch gekennzeichnet durch ausgedehnte vesikulobullöse und erosive Läsionen, her -pesähnelndes Ekzem, Gianotti-Crosti-ähnelnde Ausschläge sowie petechiale und purpurfarbene Läsionen. Wobei die sonst typischen Manifestationsorte wie Hand- und Fußinnenflächen eher ausgespart sind. Typischerweise gehen die Hautbefunde mit Juckreiz und späteren Nagelplattenablösungen einher, bei sonst geringer Komplikationsrate. Die Diagnostik erfolgt über Virus-PCR. Die Therapie erfolgt symptomatisch. Eine Prophylaxe mittels trivalentem anti-HFMK-Impfstoff ist in Erprobung.

Summary

Hand-foot-and-mouth disease is a well-known pediatric disorder. Especially studies from Asia or America report about the increasing manifestation of coxsackievirus A6 (CVA6). Therefore, the major challenge is to distinguish from other similar imposing disorders, like superinfection with herpes simplex virus or staphylococci, which are more dangerous. The CVA6 associated hand-foot-mouth disease is described here by an example and by reference to existing studies. It is clinical manifested by various vesiculobullous and erosive lesions, herpes-like eczema, Gianotto Crosti-like exanthema as well as petechial and crimson lesions. The otherwise typical manifestations on palms and soles are rather unconsidered. Typically, the cutaneous morphologies go hand in hand with pruritus and later onychomadesis by otherwise low systemic complications. Diagnosis is reached by virus-PCR. Therapy will be accomplished symptomatically. Prophylaxis trough trivalent anti-HFMK-vaccination is scheduled for trial.

Schlüsselwörter

Hand-Fuß-Mund-Krankheit - Coxsackievirus A6 - Exanthem

Keywords

Hand-foot-and-mouth disease - coxsackie -virus A6 - exanthema
 

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