Autor(es): Justino, Maria Cleonice Aguiar ; Mesquita, Deisiane da S ; Souza, Maur?cio F ; Farias, Francisco P ; Alves, Jainara Cristina dos S ; Ferreira, James L ; Lopes, Daniela P ; Tavares, Fernando Neto
Data: 2020
Origem: Oasisbr
Assunto(s): Enterov?rus / patogenicidade; Doen?a de M?o, P? e Boca / patologia; Doen?a de M?o, P? e Boca / virologia; Infec??es por Coxsackievirus / virologia; Exantema / virologia
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil.
BACKGROUND: Enterovirus (EV) A71 and coxsackievirus (CV) A16 were the most frequent serotypes involved in hand, foot, and mouth disease (HFMD) outbreaks throughout Asia. In the past 5 years, however, CV-A6 has emerged as a new important pathogen worldwide, and more severe and extensive dermatologic presentations has been reported. OBJECTIVES: Identify the clinical spectrum for atypical HFMD and enterovirus serotypes in Bel?m, Par?, Amazon region of northern Brazil. STUDY DESIGN: A prospective ambulatory clinic-based surveillance conducted from January to June 2019, involving patients under 15 years with symptoms of HFMD. Stool, serum, oropharyngeal, and skin swab samples were analyzed. Real-time RT-PCR was performed to detect the viral genome of enteroviruses. Positive specimens were submitted to semi-nested PCR. Physical examinations and demographic data were recorded on a standardized form. RESULTS: 48 patients with symptoms of HFMD were included in the study and collected all samples according to protocol. Enteroviruses were detected in 83 % of patients. An atypical form of HFMD with vesiculobullous exanthema was present in 70 % (28/40); desquamation of the palms and soles detected in 90 % (36/40) and onychomadesis in 30 % (12/40) of patients. The serotype was identified in 22 patients, CV- A6 occurred in 81.8 % of them. CONCLUSION: This is the first ambulatory surveillance and virologic investigation involving HFMD performed in outpatients from Amazon region, Brazil. The detection of CV-A6 was related to atypical forms HFMD. Desquamation of the palms and soles and nail changes occurred with frequency, such as a late sequel in the HFMD disease.
