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An unusual location of hand, foot and mouth disease

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Abstract

Hand, foot, and mouth disease (HFMD) is a childhood febrile disease. Oral lesions and papulovesicular lesions on the hands and feet are the clinical signs of the disease. In our case, a 17-year-old boy presented to the emergency department, where he was diagnosed with HFMD. After 6 days, he felt intense pain in his right testicle, and therefore an ultrasound (US) examination was performed. US detected a hypoechoic mass-like area in the right testis. Viral etiology was suspected, and no therapy was prescribed. After a little more than 3 months, US examination showed a reduced lesion size. Viral epididymo-orchitis should be suspected in young men with a recent history of HFMD and testicular pain.

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References

  1. Robinson CR, Doane FW, Rhodes AJ (1958) Report of an outbreak of febrile illness with pharyngeal lesion and exanthem: Toronto, summer 1957; isolation of group A coxsackie virus. Can Med Assoc J 79:615–621

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Kaminska K, Martinetti G, Lucchini R, Kaya G, Mainetti C (2013) Coxsackievirus A6 and hand, foot and mouth disease: three case reports of familial child-to-immunocompetent adult transmission and a literature review. Case Rep Dermatol 5(2):203–209. https://doi.org/10.1159/000354533

    Article  PubMed  PubMed Central  Google Scholar 

  3. Campbell L, Chu Y, Introcaso C, Scha er A, James W, (2013) Coxsackievirus A6—induced hand–foot–mouth disease. JAMA Dermatol 149(12):1419–1421. https://doi.org/10.1001/jamadermatol.2013.6777

    Article  Google Scholar 

  4. Blomqvist S, Klemola P, Kaijalainen S, Paananen A, Simonen ML, Vuorinen T et al (2010) Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. J Clin Virol 48:49–54

    Article  CAS  Google Scholar 

  5. Wang Y, Feng Z, Yang Y, Self S, Gao Y, Longini IM, Wakefield J, Zhang J, Wang L, Chen X, Yao L, Stanaway JD, Wang Z, Yang W (2011) Hand, foot, and mouth disease in China: patterns of spread and transmissibility. Epidemiology 22(6):781–792. https://doi.org/10.1097/EDE.0b013e318231d67a

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Zhang X, Yan HP, Huang C, Tan YF, Ma DM, Zhang HP, Liu Y, Wang SZ (2009) The etiology and clinical manifestations of 70 patients with hand–foot–mouth disease. Zhonghua Yu Fang Yi Xue Za Zhi 43(10):872–874 ((Chinese), PMID: 20137466)

    CAS  PubMed  Google Scholar 

  7. Shin JU, Oh SH, Lee JH (2010) A case of hand–foot–mouth disease in an immunocompetent adult. Ann Dermatol 22:216–218

    Article  Google Scholar 

  8. Ooi MH, Wong SC, Mohan A, Podin Y, Perera D, Clear D, del Sel S, Chieng CH, Tio PH, Cardosa MJ, Solomon T (2009) Identification and validation of clinical predictors for the risk of neurological involvement in children with hand, foot, and mouth disease in Sarawak. BMC Infect Dis 19(9):3. https://doi.org/10.1186/1471-2334-9-3

    Article  Google Scholar 

  9. Park SK, Park B, Ki M, Kim H, Lee K, Jung C, Sohn YM, Choi SM, Kim DK, Lee DS, Ko JT, Kim MK, Cheong HK (2010) Transmission of seasonal outbreak of childhood enteroviral aseptic meningitis and hand-foot-mouth disease. J Korean Med Sci 25(5):677–683. https://doi.org/10.3346/jkms.2010.25.5.677 (Epub 21 Apr 2010)

    Article  PubMed  PubMed Central  Google Scholar 

  10. Omaña-Cepeda C, Martínez-Valverde A, del Mar M, Recolons S, Jané-Salas E, Marí-Roig A, López-López J (2016) A literature review and case report of hand, foot and mouth disease in an immunocompetent adult. BMC Res Notes 9:165

    Article  Google Scholar 

  11. Osterback R, Tevaluoto T, Ylinen T, Peltola V, Susi P, Hyypiä T, Waris M (2013) Simultaneous detection and differentiation of human rhino- and enteroviruses in clinical specimens by real-time RT-PCR. J Clin Microbiol 51:3960–3967. https://doi.org/10.1128/JCM.01646-13

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hurtt R, Pound C, Bean C (2017) Benign testis mass after viral infection. Urol Case Rep 14(12):4–5. https://doi.org/10.1016/j.eucr.2017.01.001.PMID:28224088;PMCID:PMC5312462

    Article  Google Scholar 

  13. Vuorinen T, Osterback R, Kuisma J, Ylipalosaari P (2014) Epididymitis caused by coxsackievirus A6 in association with hand, foot, and mouth disease. J Clin Microbiol 52(12):4412–4413. https://doi.org/10.1128/JCM.02441-14 (Epub 17 Sep 2014)

    Article  PubMed  PubMed Central  Google Scholar 

  14. Osterback R, Vuorinen T, Linna M, Susi P, Hyypiä T, Waris M (2009) Coxsackievirus A6 and hand, foot, and mouth disease. Finland Emerg Infect Dis 15:1485–1488. https://doi.org/10.3201/eid1509.090438

    Article  CAS  PubMed  Google Scholar 

  15. Sinclair C, Gaunt E, Simmonds P, Broomfield D, Nwafor N, Wellington L, Templeton K, Willocks L, Schofield O, Harvala H (2014) Atypical hand, foot, and mouth disease associated with coxsackievirus A6 infection, Edinburgh, United Kingdom, January to February 2014. Euro Surveill 19(12):20745. https://doi.org/10.2807/1560-7917.es2014.19.12.20745 (PMID: 24698138)

    Article  CAS  PubMed  Google Scholar 

  16. Ben-Chetrit E, Wiener-Well Y, Shulman LM, Cohen MJ, Elinav H, Sofer D, Feldman I, Marva E, Wolf DG (2014) Coxsackievirus A6-related hand foot and mouth disease: skin manifestations in a cluster of adult patients. J Clin Virol 59:201–203. https://doi.org/10.1016/j.jcv.2013.12.012

    Article  PubMed  Google Scholar 

  17. Downing C, Ramirez-Fort MK, Doan HQ, Benoist F, Oberste MS, Khan F, Tyring SK (2014) Coxsackievirus A6 associated hand, foot and mouth disease in adults: clinical presentation and review of the literature. J Clin Virol 60:381–386. https://doi.org/10.1016/j.jcv.2014.04.023

    Article  PubMed  Google Scholar 

  18. La Marca A, Busani S, Donno V, Guaraldi G, Ligabue G, Girardis M (2020) Testicular pain as an unusual presentation of COVID-19: a brief review of SARS-CoV-2 and the testis. Reprod Biomed Online 41(5):903–906. https://doi.org/10.1016/j.rbmo.2020.07.017 (Epub 23 Jul 2020, PMID: 32826162)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Fernandino LV, Steven YL, Bogdana S (2020) Resolution of bilateral testicular masses after viral infection. Urol Case Rep 33:101388. https://doi.org/10.1016/j.eucr.2020.101388 (PMCID: PMC7574037; 33102086)

    Article  Google Scholar 

  20. Brillantino C, Rossi E, Minelli R, Irace D, Castelli L, Zeccolini R, Bignardi E, Tufano A (2019) A rare case of renal tumor in children: clear cell sarcoma. G Chir 40(3):217–224 (PMID: 31484012)

    CAS  PubMed  Google Scholar 

  21. Brillantino C, Rossi E, Bifano D, Minelli R, Tamasi S, Mamone R, Bignardi E, Zeccolini R, Zeccolini M, Vallone G (2020) An unusual onset of pediatric acute lymphoblastic leukemia. J Ultrasound. https://doi.org/10.1007/s40477-020-00461-y

    Article  PubMed  Google Scholar 

  22. Artul S, Abu Rahmah Y, Abu Shkara H, Yamini A (2014) Inferno: colour Doppler ultrasound sign of orchitis. BMJ Case Rep. https://doi.org/10.1136/bcr-2014-203613 (PMID: 24692383; PMC3987535)

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gkentzis A, Lee L (2014) The aetiology and current management of prepubertal epididymitis. Ann R Coll Surg Engl 96(3):181–183. https://doi.org/10.1308/003588414X13814021679311 (PMID: 24780779; PMC4474044)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Siegel A, Snyder H, Duckett JW (1987) Epididymitis in infants and boys: underlying urogenital anomalies and efficacy of imaging modalities. J Urol 138:1100–1103

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, S. Filippo Neri Hospital, Rome, Italy

    Enrico Di Lella

  2. Department of Radiological, Oncological and Pathobiological Sciences, Sapienza University of Rome, Rome, Italy

    Flavia Angelini, Sarah Campagnano, Daniela Messineo & Francesco Maria Drudi

Authors
  1. Enrico Di Lella
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  2. Flavia Angelini
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  3. Sarah Campagnano
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  4. Daniela Messineo
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  5. Francesco Maria Drudi
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Correspondence to Francesco Maria Drudi.

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Di Lella, E., Angelini, F., Campagnano, S. et al. An unusual location of hand, foot and mouth disease. J Ultrasound 25, 361–364 (2022). https://doi.org/10.1007/s40477-021-00558-y

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  • DOI: https://doi.org/10.1007/s40477-021-00558-y

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