Frontiers in pediatrics · 2026
Age-stratified clinical characteristics of hand, foot, and mouth disease in children and its guiding value for diagnosis and treatment.
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Dai Shuzhen, Hu Xiaoling, Lin Meihong, Chen Wenwen, Xu Liping
Аннотация
OBJECTIVE: To investigate the age-stratified differences in core clinical characteristics of children with hand, foot and mouth disease (HFMD) and their clinical reference value for clinical diagnosis and treatment.
METHODS: This single-center retrospective study enrolled 216 hospitalized children with HFMD from January 2022 to December 2024. Patients were stratified into four age groups: ≤1 month, 1 month-1 year, 1-3 years, and >3 years. Epidemiological features, clinical manifestations, laboratory findings, and complications were analyzed using R software.
RESULTS: Children aged 1-3 years accounted for the largest proportion (62.76%), and 88.43% of patients were under 4 years old. Neonates had a higher summer incidence and longer median hospital stay (8 days) than other age groups. Neonates presented with lower rates of rash and herpangina but significantly higher cerebrospinal fluid (CSF) protein and lower CSF glucose levels (P < 0.001). The 1 month-1 year group had the highest peripheral white blood cell (WBC) and lymphocyte counts (P < 0.001). Convulsions were most frequent in the 1-3 years group (21.48%), while >3 years group had higher rates of intracranial hypertension (24.00%). Neonates had higher rates of meningeal irritation signs (66.67%) and aseptic meningitis (73.33%) (P < 0.05). Peripheral WBC and neutrophil counts were positively correlated with C-reactive protein (CRP) and procalcitonin levels; CSF WBC was correlated with CSF protein and peripheral blood leukocyte indices.
CONCLUSION: HFMD shows significant age-related clinical heterogeneity. Neonatal infections tend to follow a relatively benign course with prominent CSF abnormalities, whereas older children are more prone to neurological complications. Age-stratified diagnostic and management strategies may facilitate early risk identification and improve clinical outcomes.
METHODS: This single-center retrospective study enrolled 216 hospitalized children with HFMD from January 2022 to December 2024. Patients were stratified into four age groups: ≤1 month, 1 month-1 year, 1-3 years, and >3 years. Epidemiological features, clinical manifestations, laboratory findings, and complications were analyzed using R software.
RESULTS: Children aged 1-3 years accounted for the largest proportion (62.76%), and 88.43% of patients were under 4 years old. Neonates had a higher summer incidence and longer median hospital stay (8 days) than other age groups. Neonates presented with lower rates of rash and herpangina but significantly higher cerebrospinal fluid (CSF) protein and lower CSF glucose levels (P < 0.001). The 1 month-1 year group had the highest peripheral white blood cell (WBC) and lymphocyte counts (P < 0.001). Convulsions were most frequent in the 1-3 years group (21.48%), while >3 years group had higher rates of intracranial hypertension (24.00%). Neonates had higher rates of meningeal irritation signs (66.67%) and aseptic meningitis (73.33%) (P < 0.05). Peripheral WBC and neutrophil counts were positively correlated with C-reactive protein (CRP) and procalcitonin levels; CSF WBC was correlated with CSF protein and peripheral blood leukocyte indices.
CONCLUSION: HFMD shows significant age-related clinical heterogeneity. Neonatal infections tend to follow a relatively benign course with prominent CSF abnormalities, whereas older children are more prone to neurological complications. Age-stratified diagnostic and management strategies may facilitate early risk identification and improve clinical outcomes.