This protocol addresses hand, foot and mouth disease or herpangina presenting with central nervous system involvement in the form of aseptic meningitis — febrile illness with headache, vomiting, and meningism, accompanied by cerebrospinal fluid pleocytosis (more than 5–10 white cells per cubic millimeter) and negative CSF bacterial culture.
Patients in this sub-population show signs of meningeal irritation (meningism) with an inflammatory CSF picture but no evidence of bacterial infection. The overall prognosis is generally favourable.
Management is symptomatic in nature, centred on supportive care. The full structured regimen — including specific agents, sequencing, and all relevant clinical decision points — is available via the link below.