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November 1974

Hand-Foot Syndrome and Streptococcal Sepsis

Author Affiliations

Department of Pediatrics Southern California Permanente Medical Group Kaiser Foundation Hospital 13652 Cantara St Panorama City, CA 91402

Am J Dis Child. 1974;128(5):743. doi:10.1001/archpedi.1974.02110300153025

The hand-foot syndrome rarely occurs in children who do not have a sickle cell disorder, and it appears to be even less common in association with streptococcal infection. Haltalin and Nelson described an 8-month-old black boy with normal hemoglobin and painful swelling of his hands and feet as a result of infection with group A, β-hemolytic streptococcus.2 A second patient with staphylococcal infection and normal hemoglobin was commented on briefly by Waldvogel and co-workers in a recent review of osteomyelitis.3

Infants and young children with sickle cell hemoglobinopathies may develop the hand-foot syndrome as a result of either intraosseous sickling or, less commonly, from Salmonella osteomyelitis.1 Initial manifestations of the syndrome include fever and leukocytosis, followed by bilateral painful swelling of the hands or feet or both. Roentgenograms taken early in the course of illness generally show no abnormalities, but after 7 to 14 days, the picture

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