CASE  4

In September, a 3- year-old black male presented to his pediatrician with a 1 day history of fever to 101.5^o F. The child complained of pain when swallowing and the mother had begun to see small bumps on the palms and soles of the feet. Physical examination revealed several pharyngeal ulcerations and papulovesicular lesions on the palms and soles. A clinical diagnosis of enteroviral infection was made. The next week, the boy’s 8-year-old brought home a note from school describing a recent outbreak of this disease (see attached note).

Questions

1. How is the virus transmitted?
   

2. What caused the pharyngeal ulcerations and papulovesicular lesions?
   

3. Why did the physician make a clinical diagnosis instead of ordering laboratory tests to identify the infectious agent?
   

4. Are other family members likely to become infected?
   

5. Will the child have recurrent infections?