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Enfermedad mano pie boca 2016

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Enfermedad mano pie boca

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Enfermedad mano pie boca 2016

  1. 1. ENFERMEDAD MANO-PIE-BOCA Gianfranco Argomedo Ramos Trujillo -2016
  2. 2. ¿Qué es? La enfermedad mano pie boca se considera dentro de las enfermedades exantemáticas en pediatría. •Exantema: Erupción cutánea que puede darse en el contexto de una enfermedad que afecta el organismo. Sarampión. 1° enfermedad Escarlatina. 2° enfermedad Rubéola. 3° enfermedad Enf. de Filatow-Dukes. 4° enfermedad Eritema Infeccioso. 5° enfermedad Exantema súbito. 6° enfermedad Exantemas por enterovirus: Enfermedad Mano-pie- boca Exantema periflexural asimétrico de la infancia Exantema por virus de Epstein-Barr Síndrome de Gianotti-Crosti Edema agudo hemorrágico infantil Pitiriasis rosada Varicela Enf. de Kawasaki
  3. 3. • Son erupciones constituidas por las lesiones más variadas( máculas, pápulas, vesículas, pústulas, petequias), son frecuente motivo de consulta en la edad pediátrica. • La mayoría de estos exantemas es autolimitada y queda catalogada como ‘virales’ sin haberse alcanzado un diagnóstico etiológico(causa). •*Herpesvirus •• Adenovirus •• Picornavirus •• Parvovirus •• Togavirus •• Paramixovirus •• Poxvirus •• Retrovirus
  4. 4. ¿y en este caso quién la produce? Coxsackie virus A16, A4 -7, A9, A10, B2 y B5 Enterovirus 71. • Familia de los picornavirus, genero enterovirus. • Su transmisión es fundamentalmente fecal-oral • Diseminación asintomática hasta por un mes. • Deficiente higiene, residuos. • Verano y otoño estaciones propicias. • Coxsackie pueden transmitirse por partículas aerosólicas.
  5. 5. ¿A quienes afecta ? •Principalmente a pre escolares, en menor cantidad a menores de 10 años, rara vez a adultos. •No diferencia entre sexos.
  6. 6. ¿Cómo se transmite?  Persona a Persona (fludge)  Contacto directo con manos sucias o superficies contaminadas con heces.  Es posible que se trasmitan a través de objetos contaminados de los enfermos. • contacto directo con saliva, ampollas de la boca, líquido de ampollas en las manos y en los pies
  7. 7. • PERIODO DE INCUBACION 3 a 7 días Implantación viral inicial oral nódulos linfáticos regionales (24H) Virema 72 horas Mucosa oral Manos y pies 7º día elevación de anticuerpos declinación de la enfermedad
  8. 8. ¿Cómo lo distinguimos? INCUBACIÓN: 3-6 ó 7 días •PRÓDROMOS (12-24 hrs.): febrícula, malestar general, dolor abdominal y síntomas respiratorios, asintomático.
  9. 9. Periodo Clínico • Vesículas o erupciones en mucosa oral, paladar duro, lengua. •3 y 7 mm pared delgada tipo ulcerativa con un halo eritematoso, ovales o lineales pero no circulares
  10. 10. PIEL: (palmas y plantas, dedos, gluteos), concomitante u horas después • Máculas o pápulas rosadas o rojas, de 2-8mm, múltiples, con configuración “Lineal” • Evolucionan a vesículas (líq. claro o amarillento)
  11. 11. Formación de erosiones y costras Asintomáticas o dolorosas, no producen prurito Curan sin cicatrización Síntomas asociados: eritema faríngeo, fiebre, malestar gral., diarrea, dolor articular, raro sintomatología Neurológica.
  12. 12. • Anamnesis • Examen Físico • Detección del virus en el líquido de la ampolla por reacción en cadena de la polimerasa (PCR). Puede detectar enterovirus con una sensibilidad de aproximadamente el 90 por ciento, que no permite la identificación del serotipo. • Coxsackievirus A16 secuenciación de nucleótidos se puede realizar en muestras positivas de PCR para confirmar el diagnóstico
  13. 13. DIAGNOSTICO DIFERENCIAL HERPANGINA Úlceras pequeñas de 2 a 4 mm. de diámetro localizadas en paladar blando y pilares amigdalianos GINGIVOESTOMATITIS HERPETICA Lesiones en toda la mucosa oral incluyendo la encía adherida y en forma de roseta ESCABIOSIS Vesículas en manos, pliegues y pies pruriginosas de color violaceo
  14. 14. Tratamiento •El tratamiento indicado es solamente el alivio sintomático. • Se ha intentado administrar aciclovir durante el 1º o 2º días posteriores al exantema pero es totalmente ineficaz como cualquier otro antiviral, puesto que parece que el propio interferón del paciente es el responsable de la mejoría y desaparición de la enfermedad.
  15. 15. • LIQUIDOS FRECUENTES, PEQUEÑA CANTIDAD, UN POCO FRESCO. • NO ALIMENTADOS CONDIMIENTADOS.
  16. 16. Prevención Lávese las manos con agua y jabón frecuentemente durante 30 segundos, en especial después de cambiar pañales, antes de preparar los alimentos y de comer, al estar en contacto con mocos, flema, materia fecal o líquido de las ampollas.
  17. 17. •Evite tocarse los ojos, la nariz y la boca antes de lavarse las manos.
  18. 18. •Evite el contacto directo (besar, abrazar, compartir tazas y cubiertos) con personas infectadas.
  19. 19. •Desinfecte con frecuencia las superficies que se tocan (los juguetes, las manijas de las puertas, etc.), especialmente si alguien está enfermo.
  20. 20. • Los juguetes y las superficies deben lavarse primero con solución de agua y jabón y luego deben limpiarse con una solución de lejía diluida (agregar ¼ de taza de lejía en un galón de agua).
  21. 21. •Estas medidas preventivas las debemos tener en cuenta no SOLAMENTE ANTE UN BROTE sino SIEMPRE, PUES LOS VIRUS PUEDEN ESTAR PRESENTES antes y después que se presenten los síntomas.
  22. 22. •Los niños con Enfermedad mano-pie-boca de preferencia deben permanecer en su casa y no asistir a la guardería o a la escuela hasta que transcurra 24 horas luego del cese la fiebre y las ampollas hayan sanado. •Los adultos enfermos deben permanecer en su casa y no asistir al trabajo hasta que los síntomas desaparezcan.

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