Family Health Guide

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Rashes: Coxsackie


The coxsackievirus can harmlessly exist in the digestive tract at any given time and produce no symptoms, however some kids with coxsackie can develop a high fever and telltale tiny, painful, red blisters that make them extremely irritable (and their moms extremely stressed!). The coxsackie strain known as hand, foot and mouth disease, produces blisters on the fingers, toes, gums, tongue, throat or the inside of cheeks. Some children have one or two isolated blisters, others will have dozens. Another type of coxsackie commonly causes an infection called herpangina, which results in blisters that look like red rings in the back of the throat and tonsils. Fever usually lasts two or three days, but the blisters can remain for a week or more. If your child has a high fever for more than a few days, a bad headache and/or a stiff neck, call your doctor. Although rare, she could have viral meningitis, a serious complication of coxsackie that infects the spinal cord. 


The virus spreads easily between people, usually through hand-to-hand contact, sneezes or coughs, or exposure to (eww) fecal matter on common surfaces. It tends to spread most easily during the warmest months of the year. Kids under 5 are most susceptible; older children and adults will often show no or few symptoms when exposed. Because there are several different strains, your child might come down with coxsackievirus more than once. 


A pediatrician can determine whether a child has coxsackie by examining the blisters and assessing other symptoms, like fever. Swabs may be taken and sent to a lab as well. 


Since coxsackie is highly contagious, clean your child’s hands with warm, soapy water (or if you’re not close to a sink, an alcohol-based sanitizer) after school, day-care, a visit to the playground, or post-potty. Wash your own hands thoroughly after changing diapers or going to the bathroom, and before preparing food. If one child in your family has the virus, don’t allow sibs to share food or drinks until more than 24 hours after the fever has broken. A couple times a day, wipe down toys and hard surfaces in the house with hot, soapy water or a disinfecting spray. 


There’s no medication to cure coxsackie, but blisters heal in a week or two on their own. In the mean time, you can help bring down a fever and reduce the pain from blisters with acetaminophen or ibuprofen. If your child has neck pain or a severe headache along with symptoms, or a fever lasting more than a few days, see a doctor immediately to rule out viral meningitis, which can lead to brain damage and death, and should be closely monitored by a physician. Call your doctor if your child has a fever of over 100.4, nausea or vomiting, abdominal discomfort, difficulty breathing, or sores inside the mouth. 

Complementary/Alternative Treatments

Cold dairy products like milk, ice cream and yogurt can help soothe blisters in the throat (avoid acidic drinks like orange juice, which can irritate them). You can also dip a cotton swab in a mixture of one teaspoon Benadryl (oral diphenhydramine) and one teaspoon liquid antacid (like regular Maalox, not Maalox Total Relief) and gently swab it over your child’s mouth sores a few times a day, which may reduce pain. (Check with your doctor before trying this solution to make sure you aren’t using too much; diphenhydramine can be absorbed through the skin, so there’s a risk of overdose)