Atypical presentations of hand, foot, and mouth disease caused by CVA6 can mimic varicella, highlighting the importance of molecular testing for accurate diagnosis and appropriate clinical management.
Atypical HFMD presentations may mimic varicella; case reports leave open the need for prospective diagnostic studies.
In June, 2014, the Minnesota Department of Health (MDH) was notified of a suspected varicella case in a child aged 2 years. The patient had a generalized rash with relative sparing of the trunk and was hospitalized overnight for treatment of dehydration. The child's mother, who was near the end of a pregnancy, also had a generalized rash, which included the perineal area. Identifying the cause of the rash was important to determine whether administration of varicella zoster immune globulin was indicated to prevent neonatal varicella. Enterovirus was detected in specimens from the woman and child by reverse transcriptase-polymerase chain reaction (RT-PCR) testing performed at MDH; partial genome sequencing by CDC showed that both patients were infected with coxsackievirus A6 (CVA6), one of the members of the genus Enterovirus that causes hand, foot, and mouth disease (HFMD).
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Buttery et al. (2015) studied this question.
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