{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:20:49Z","timestamp":1783405249161,"version":"3.54.6"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the age-stratified differences in core clinical characteristics of children with hand, foot and mouth disease (HFMD) and their clinical reference value for clinical diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study enrolled 216 hospitalized children with HFMD from January 2022 to December 2024. Patients were stratified into four age groups: \u22641 month, 1 month\u20131 year, 1\u20133 years, and &amp;gt;3 years. Epidemiological features, clinical manifestations, laboratory findings, and complications were analyzed using R software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Children aged 1\u20133 years accounted for the largest proportion (62.76%), and 88.43% of patients were under 4 years old. Neonates had a higher summer incidence and longer median hospital stay (8 days) than other age groups. Neonates presented with lower rates of rash and herpangina but significantly higher cerebrospinal fluid (CSF) protein and lower CSF glucose levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The 1 month\u20131 year group had the highest peripheral white blood cell (WBC) and lymphocyte counts (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Convulsions were most frequent in the 1\u20133 years group (21.48%), while &amp;gt;3 years group had higher rates of intracranial hypertension (24.00%). Neonates had higher rates of meningeal irritation signs (66.67%) and aseptic meningitis (73.33%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Peripheral WBC and neutrophil counts were positively correlated with C-reactive protein (CRP) and procalcitonin levels; CSF WBC was correlated with CSF protein and peripheral blood leukocyte indices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HFMD shows significant age-related clinical heterogeneity. Neonatal infections tend to follow a relatively benign course with prominent CSF abnormalities, whereas older children are more prone to neurological complications. Age-stratified diagnostic and management strategies may facilitate early risk identification and improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1840062","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:46:40Z","timestamp":1783403200000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-stratified clinical characteristics of hand, foot, and mouth disease in children and its guiding value for diagnosis and treatment"],"prefix":"10.3389","volume":"14","author":[{"given":"Shuzhen","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Neonatology, Zhangzhou Affiliated Hospital of Fujian Medical University","place":["Zhangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Zhangzhou Affiliated Hospital of Fujian Medical University","place":["Zhangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meihong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Zhangzhou Affiliated Hospital of Fujian Medical University","place":["Zhangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Zhangzhou Affiliated Hospital of Fujian Medical University","place":["Zhangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Zhangzhou Affiliated Hospital of Fujian Medical University","place":["Zhangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0008885","DOI":"10.1371\/journal.pntd.0008885","article-title":"An epidemiological surveillance of hand foot and mouth disease in paediatric patients and in community: a Singapore retrospective cohort study, 2013\u20132018","volume":"15","author":"Min","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"101603","DOI":"10.1016\/j.lanwpc.2025.101603","article-title":"Epidemiology of hand, foot, and mouth disease outbreaks before and during availability of EV-A71 vaccine in China's Mainland: analysis of outbreak surveillance data from 2011 to 2023","volume":"59","author":"Liu","year":"2025","journal-title":"Lancet Reg Health West Pac"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e58704","DOI":"10.7759\/cureus.58704","article-title":"Epidemiological and clinical profile of hand, foot, and mouth disease in children in a tertiary care center in Jammu","volume":"16","author":"Khajuria","year":"2024","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2400","DOI":"10.1080\/21645515.2015.1059980","article-title":"Disease burden of enterovirus 71 in rural central China: a community-based survey","volume":"11","author":"Gan","year":"2015","journal-title":"Hum Vaccin Immunother"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0147532","DOI":"10.1371\/journal.pone.0147532","article-title":"Spatiotemporal cluster patterns of hand, foot, and mouth disease at the county level in mainland China, 2008\u20132012","volume":"11","author":"Wang","year":"2016","journal-title":"PLoS One"},{"key":"B6","doi-asserted-by":"publisher","first-page":"4934\u2013","DOI":"10.1002\/jmv.27906","article-title":"Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016\u20132020 in Beijing, China","volume":"94","author":"Cui","year":"2022","journal-title":"J Med Virol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"543013","DOI":"10.3389\/fneur.2020.543013","article-title":"Analysis of clinical related factors of neonatal hand-foot-mouth disease complicated with encephalitis","volume":"11","author":"Fang","year":"2020","journal-title":"Front Neurol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"3000605241304636","DOI":"10.1177\/03000605241304636","article-title":"Correlation analysis of serum inflammatory cytokine levels and immune markers in children with severe hand, foot and mouth disease","volume":"52","author":"Li","year":"2024","journal-title":"J Int Med Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1055\/s-0040-1708053","article-title":"Diagnostic and prognostic values of blood test parameters in hand, foot, and mouth disease: a meta-analysis","volume":"15","author":"Zhang","year":"2025","journal-title":"J Pediatr Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"l","DOI":"10.1155\/2016\/4025167","article-title":"Interleukin-27 as a novel biomarker for early cardiopulmonary failure in enterovirus 71-infected children with central nervous system involvement","volume":"2016","author":"Huang","year":"2016","journal-title":"Mediators Inflamm"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.4238\/gmr.15038744","article-title":"Clinical significance of combined liver function and high-sensitivity C-reactive protein measurement in children with hand-foot-mouth disease","volume":"15","author":"Han","year":"2016","journal-title":"Genet Mol Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.pid.2015.12.001","article-title":"The relevance of the serum levels of C-reactive protein and creatine kinase-MB to the severity of hand-foot-and-mouth disease patients in China: a meta-analysis","volume":"8","author":"Ran","year":"2025","journal-title":"Pediatr Infect Dis"},{"key":"B13","volume-title":"National Health and Family Planning Commission of the People's Republic of China","year":"2018"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e12042","DOI":"10.1016\/j.heliyon.2022.e12042","article-title":"Age-specific transmission for different virus serotypes of hand, foot and mouth disease and the impact of interventions in East China, 2009\u20132015","volume":"8","author":"Le","year":"2022","journal-title":"Heliyon"},{"key":"B15","doi-asserted-by":"publisher","first-page":"4922","DOI":"10.3390\/jcm13164922","article-title":"Coxsackievirus group B infections during pregnancy: an updated literature review","volume":"13","author":"Longo","year":"2024","journal-title":"J Clin Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e929","DOI":"10.1542\/peds.2006-0554","article-title":"Probable intrafamilial transmission of coxsackievirus b3 with vertical transmission, severe early-onset neonatal hepatitis, and prolonged viral RNA shedding","volume":"118","author":"Cheng","year":"2006","journal-title":"Pediatrics"},{"key":"B17","doi-asserted-by":"publisher","first-page":"4919","DOI":"10.3390\/ijerph18094919","article-title":"Spatial and temporal characteristics of hand-foot-and-mouth disease and their influencing factors in Urumqi, China","volume":"18","author":"Gao","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"8900","DOI":"10.1038\/s41598-017-09196-z","article-title":"Epidemiological characteristics of hand, foot, and mouth disease in Shandong, China, 2009\u20132016","volume":"7","author":"Wang","year":"2017","journal-title":"Sci Rep"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1377861","DOI":"10.3389\/fpubh.2024.1377861","article-title":"Epidemiological and etiological investigations of hand, foot, and mouth disease in Jiashan, northeastern Zhejiang Province, China, during 2016 to 2022","volume":"12","author":"Yuan","year":"2024","journal-title":"Front Public Health"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1840062\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:46:41Z","timestamp":1783403201000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1840062\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":19,"alternative-id":["10.3389\/fped.2026.1840062"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1840062","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"article-number":"1840062"}}