Halloween & Hand, Foot Mouth Disease

I was reminded of how much fun Halloween can be last week during the costume contest on the wards. The day before, our chief resident made an announcement during noon conference to remind us to dress up for the kids. I was a gypsy, which was not nearly as creative as the Mickey Mouse, pirates, fairies, cowboys, Pippy Long stockings, and other characters. As we walked around the wards, it was uplifting to see some of the patients dressed up and getting to Trick-or-Treat at different places on the floor.

Post-Halloween, I spent my day in the ED during a day shift.

When I spoke with a kid with a possible wrist fracture, I asked him why he waited to come to the ED (he had sustained the injury the day before) and he had the most adorable response.

"I would have come on Saturday, but I wanted to go Trick-or-Treating."

Now, there is a kid with his priorities straight.

***

For the first time, there is something in medicine that is appropriately named- hand, foot and mouth disease.

During urgent care clinic today, I met a very cute four year old boy, who was been feeling awful over the last weeks with fevers, diarrhea, mouth ulcers, and diarrhea. He also had some interesting rashes on his palms and soles. As I listened to the story from his grandma, I started to put two and two together; he has problems with his hands and feet (rashes) and mouth (ulcers) in the setting of an infectious process (fever and diarrhea).

Like a simple math equation, it all added up to one thing- hand, foot and mouth disease, which is a coxsackie virus infection. Treatment is mostly supportive (fluids, rest, and Motrin) and the symptoms will likely resolve with time. Poor kid.

***

My days in urgent care have been a mix of evaluating upper respiratory infections (mostly coughs, runny noses and fevers) and some other interesting things, including jaundiced newborns, kids who have been vomiting, kids with diarrhea and strep throat.

On my call days in the Emergency department, I took care of a six year old boy, who sustained a wrist injury while dribbling a ball in a soccer match. I was the first to sign his cast with my signature sparkly Sponge Bob stickers. I also saw a toddler with gastroenteritis and a 16 y/o with vomiting.

In my one week of experience, I am really enjoying working with the kiddos and am beginning to see the "bread and butter" of pediatrics, which is still very novel to me during my second week of pediatrics.