Hand, Foot, and Mouth Disease with Probable Intrafamilial Transmission in a 15-Month-Old Infant: A Case Report

Hand, foot, and mouth disease (HFMD) is an acute exanthema disease caused by a viral infection which is generally self-limiting, most often caused by Coxsackievirus A16 and Enterovirus 71, and more often attacks children under five years of age. Problem: Transmission within the family through direct contact with secretions or lesion fluid from infected individuals is a recognized transmission route, however case reports that specifically state the possibility of intrafamilial transmission in children under two years old are still rare in the literature. Case report: We report a case of HFMD in a 15 month old boy who was brought to the outpatient facility with complaints of reddish rashes around the mouth, hands and feet since two days previously, preceded by fever as a prodromal symptom. Physical examination showed maculopapular and vesicular lesions in the perioral region, right wrist, and bilateral lower extremities, with generalized distribution and miliary to lenticular size. A history of close contact with an older sibling who experienced similar symptoms approximately one week previously supports the possibility of intrafamilial transmission between siblings. Management: The diagnosis is made clinically without laboratory supporting examinations. The patient received supportive treatment in the form of paracetamol syrup, 2% mupirocin ointment, and immunostimulants, accompanied by education to parents regarding hand hygiene and isolating the patient from other family members. Conclusion: This case emphasizes the importance of a systematic history of intrafamilial contact history in children with suspected HFMD, as well as the need for targeted family education to break the chain of transmission in the household environment.