Enfermedad mano - pie y boca en una paciente adulta inmunocompetente. Reporte de caso y revisión de literatura.

Dra. Andrea Arias Argüello
Médico Cirujano General. Colorado. Estados Unidos.
Consulta privada, trabajador independiente.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica.
Costa Rica.

Resumen

La enfermedad de mano-pie-boca (EMPB) es un síndrome clínico atribuido a la infección viral ocasionada por el grupo de Enterovirus, incluyendo el Coxsackievirus A16 y el Enterovirus 71, se transmite por vía fecal-oral, a través de secreciones orales-faríngeas o por contacto directo con la piel. Es altamente contagiosa, afecta predominantemente a niños menores de cinco años y es mucho menos común en adultos, en quienes se presenta con manifestaciones atípicas.

En este artículo, se describe el caso de una paciente de género femenino de treinta y cinco años, sana e inmunocompetente, con presentación clínica atípica: enantema oral mínimo y erupción vesicular en el cuero cabelludo, lesiones purpúricas dolorosas en palmas y plantas. Las lesiones cutáneas se resolvieron espontáneamente en una semana. Este caso enfatiza el hecho subestimado de que la enfermedad de mano-pie-boca también puede ocurrir en adultos, ya sea típica o con frecuencia atípica y la necesidad de alta sospecha clínica. Junto con la presentación del caso, se realizó una revisión de la literatura que describe la variable sintomatología en adultos, destacando el papel del virus Coxsackie A16.

Palabras claves

Enfermedad mano-pie-boca, Enterovirus, Coxsackievirus.

Abstract

Hand-foot-mouth disease (HFMD) is a clinical syndrome attributed to viral infection caused by the Enterovirus group, including Coxsackievirus A16 and Enterovirus 71, transmitted by the fecal-oral route, through oral secretions- pharyngeal or by direct contact with the skin. It is highly contagious, predominantly affects children under five years of age and is much less common in adults, in whom it presents with atypical manifestations.

The case of a 35-year-old female patient, healthy and immunocompetent, with atypical clinical presentation is described: minimal oral enanthem and vesicular rash on the scalp, painful purpuric lesions on palms and plants. The skin lesions resolved spontaneously in one week. This case emphasizes the underestimated fact that hand, foot and mouth disease can also occur in adults, whether typical or often atypical and the need for high clinical suspicion. Along with the presentation of the case, a review of the literature describing the symptomatology variable in adults was carried out, highlighting the role of coxsackie A16 virus.

Keywords

Hand-foot-mouth disease, enterovirus, coxsackievirus.

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