Chickenpox vs Hand Foot and Mouth | Causes, Clinical Features, Complications, Diagnosis, Management
Chickenpox and hand foot and mouth disease, both of which are caused by viral infections, share some of the common characteristics and causes diagnostic confusion. But several features of the two diseases are significantly different. This article points out the differences between chickenpox and hand foot mouth disease with regard to the organism responsible, clinical picture, complications, diagnosis and management.
What is Chickenpox?
Varicella zoster, which belongs to the herpes virus family, is responsible for the disease. It is a DNA virus and has an ability to cause latent infections. The disease transmission is by respiratory droplets and direct contact with the lesions. It is highly infectious and more severe in adults, pregnant women and immune compromised people. Immunity following the disease is a lifelong.
Following an incubation period of 14-21 days vesicular eruption begins, often on the mucosal surfaces first and then rapid dissemination in a centripetal distribution mostly involving the trunk. The rash progresses from small pink macules to vesicles and pustules within 24 hours and then crust. The lesions appear to be in different stages of development. The pocks are more superficial, and the vesicles collapse on puncture.
The lesions are itchy, and scratching can lead to secondary bacterial infection, which is the most common complication. Rare complications involve self-limiting cerebella ataxia, varicella pneumonia, encephalitis and Reye’s syndrome especially in children who are on aspirin.
Clinical diagnosis is made by the classic appearance of the rash. Aspiration of the vesicular fluid and PCR or tissue culture confirms the diagnosis.
Acyclovir is effective in the management of the disease, especially, if commence within 48 hours of the rash. Live attenuated VZV is given for highly susceptible contacts.
What is Hand Foot and Mouth Disease?
It is a systemic infection caused by coxsackie virus A16, which belongs to picornaviridae family. The disease is moderately infectious. Transmission of the disease is by direct contact with mucus, saliva or feces of an infected person. It mostly affects children and rarely adults.
Following an incubation period of 10 days, mild illness of fever and lymphadenopathy occur. After 2-3 days vesicular rash appears on palmoplanter surfaces of the hands and feet with associated mouth lesions that ulcerate rapidly. Papular erythematous rash may appear on buttocks and thigh, as well.
Isolating the virus or observing a rise in titer of neutralizing antibodies help in making the diagnosis.
The disease is self limiting and usually resolves within 2 weeks after the onset. In case if the lesions are painful, analgesics can be given. Passive immunization is not recommended.
The complications of the disease are very rare including mild viral meningitis, encephalitis and paralysis.
What is the difference between chickenpox and hand foot and mouth disease?
• Chickenpox is caused by a herpes virus while hand foot mouth disease is caused by a picorna virus.
• Incubation period of chickenpox is 14-21 days, but in hand foot and mouth disease, it is 10 days.
• In chickenpox, lesions appear mostly in the trunk, but in hand foot mouth disease, they appear on palmoplanter surfaces of the hands and feet with associated mouth lesions that ulcerate rapidly.
• Chickenpox needs to be treated with acyclovir but hand foot mouth disease is self limiting.
• Effective vaccine is available against chickenpox but no need for the hand foot mouth disease.
• Chickenpox is highly infectious, but hand foot mouth disease is moderately infectious.
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