Coxsackie in children: how it runs, why it is dangerous and what to watch

Coxsackie is not a separate illness but a group of viruses belonging to the enteroviruses. The same viruses produce different pictures in different children: one gets a mild upset with a fever, another the recognisable combination of spots on the hands and feet with painful mouth ulcers known as hand, foot and mouth disease.

What “hand, foot and mouth” means

It is a descriptive name rather than a separate diagnosis: the spots sit mainly on the hands, feet and around the mouth, and painful spots and ulcers appear inside the mouth. The illness often starts with a fever and loss of appetite, with the spots appearing later. In some children there are almost no spots, and only the fever and mouth pain remain.

The main problem is not the rash but the mouth

The skin spots usually do not bother the child and go away on their own. The danger comes from something else: the mouth ulcers make swallowing painful, the child refuses to drink and eat, and within a day this can lead to a fluid shortage — especially in toddlers.

• Offer drinks often and in small amounts, without insisting on a large volume at once.
• Cool drinks and cool soft food are usually tolerated better than hot ones.
• Sour, salty and spicy foods make the pain worse — best avoided on these days.
• Refusing food for a few days is tolerated normally; refusing to drink is not.
• Pain relief and any medicines are prescribed for the child by a doctor: this article contains no doses or treatment plans.

How to notice that fluid is running short is covered in detail in a separate article — which also explains why the severity of dehydration cannot be determined at home.

Temperature and general condition

The fever usually lasts a short time, early in the illness. You should be guided not by the number on the thermometer but by how the child looks and behaves: are they drinking, responding as usual, can they be settled. If the fever returns after a clear improvement or lasts more than a few days, the child should be seen by a doctor.

The skin after the illness

Some time after recovery the skin on the palms and soles may peel, and the nails sometimes change and later grow back afresh. This looks unpleasant but does not in itself mean a complication. If the changes come with pain, swelling or redness, they are worth showing to a doctor.

Is a test needed

In typical cases laboratory confirmation is not required: it changes neither the monitoring nor the recommendations. Testing is discussed when the picture is atypical, the course drags on, or the doctor is considering other causes. The specific virus cannot be identified from the appearance of the spots — not by a doctor, and certainly not from a photograph on the internet.

Contagiousness and what to do in the family

Enteroviruses spread easily — via hands, objects, saliva and gut contents — and the virus keeps being shed after the symptoms have gone. Completely breaking transmission within a family is therefore usually impossible. What genuinely helps: thorough handwashing, separate towels and dishes, cleaning surfaces and toys.

This page is for general information only and is not a substitute for a consultation with a doctor. A child's diagnosis and treatment are determined by a doctor during an examination.