Many children with severe hand, foot and mouth disease need ventilators and dialysis after 3 days of fever.

According to the Ho Chi Minh City Department of Health, last week, the city recorded 423 cases, an increase of 142.4% compared to the average of the previous 4 weeks. Of which, the number of cases increased in both inpatient hospitalizations and outpatient examinations compared to the average of the previous 4 weeks. Last week, most districts recorded an increase in the number of cases compared to the average of the previous 4 weeks (19/22 districts).

Many cases require intubation and blood filtration.

On June 17, Dr. Nguyen Minh Tien, City Children's Hospital, said that recently the hospital has continuously received many cases of severe hand, foot and mouth disease that progressed rapidly. The disease became severe after only 2 days of fever, progressing to level 3 and 4, requiring dialysis combined with many treatment methods.

The first case was baby NGL (8 months old, living in Vinh Long). The first two days, the baby had fever, vomiting, rash with blisters on the palms of the hands and feet. On the third day, the baby had a fever and started to feel dizzy, rolled his eyes and had trembling limbs, so he was admitted to the local hospital. He was diagnosed with grade 3 hand, foot and mouth disease. After treatment according to the regimen, the condition did not improve, so he was transferred to the City Children's Hospital.

Here, the child showed signs of lethargy, weak pulse, cool skin, heart rate greater than 200 beats/minute, continuous high fever, diagnosed with grade 4 hand, foot and mouth disease. Test results showed high cardiac enzymes, slightly increased liver enzymes, severe metabolic acidosis, treated with intubation to help breathing, anti-shock with vasopressor fluids, sedation, and active fever reduction. The condition did not improve, so continuous blood filtration was performed.

After 2 days of treatment, the child's condition improved, fever reduced, heart rate decreased to 145-150 beats/minute, hemodynamics were stable, vasopressor drugs were gradually reduced, and active monitoring and treatment continued.

TP.HCM: Nhiều trẻ mắc tay chân miệng nặng phải thở máy, lọc máu sau 3 ngày sốt - Ảnh 1. — 3-year-old child diagnosed with hand, foot and mouth disease level 3, treated with ventilator

Similar to boy PHT (2 years old, living in Tra Vinh), boy P.D.K (3 years old, living in An Giang), girl NNHM (6 years old, living in Ba Ria Vung Tau) after the first 2 days of fever, red rash with blisters on the palms of the hands and feet, on the 3rd day of fever, startled and dizzy, so they were admitted to the local hospital, diagnosed with grade 3 hand, foot and mouth disease, treated according to the regimen but the condition did not improve so they were transferred to the City Children's Hospital.

Here, the children showed signs of lethargy, high heart rate, vomiting, high fever, and were treated according to the protocol, endotracheal intubation to help with breathing, and intravenous immunomodulators and antipyretics... After 3 days of treatment, the children recovered and their condition improved. All 4 cases had PCR tests of rectal swabs that showed EV7 infection.

At the Intensive Care - Anti-Poison Department, Children's Hospital 1 (HCMC) is also treating 4 severe cases of hand, foot and mouth disease, all 4 cases require ventilators, of which 1 case requires dialysis.

Symptoms of severe hand, foot and mouth disease and measures to prevent it

Dr. Tien said that parents need to pay attention when they see their children have a fever, rash with blisters on the hands, feet, buttocks, knees, mouth ulcers, accompanied by symptoms such as being startled, vomiting a lot, high fever that is difficult to reduce, abnormal breathing, shaking hands and feet, staggering, sitting unsteadily, difficulty swallowing, skin rash (purple veins), paleness, lethargy, convulsions, etc. When the above signs appear, take the child to the hospital for timely examination and treatment by doctors.

Parents should take precautions to prevent their children from getting hand, foot and mouth disease by practicing personal hygiene, eating cooked food and drinking boiled water, and not sharing personal items (towels, toothbrushes, bowls, chopsticks, spoons, etc.). Wash your hands with soap after changing clothes, diapers, after contact with feces, urine, saliva, before and after preparing food. Clean toys, utensils, floors, handrails, doorknobs, etc.

Instruct children to wash their hands with soap under running water. Wash hands before and after eating, after playing with toys, older children wash hands after using the toilet, wash hands when dirty. When children are sick, they need to be isolated for 8-10 days, the care process should avoid breaking the blisters and spreading the disease.

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