Objective:

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.

Approach:

• Study Design: Single-center retrospective study enrolling 216 hospitalized children with HFMD from January 2022 to December 2024, stratified into four age groups.
• Data Collection: Analysis of epidemiological features, clinical manifestations, laboratory findings, and complications using R software.

Key Findings:

• Children aged 1–3 years accounted for 62.76% of cases, with 88.43% under 4 years old.
• Neonates had a higher summer incidence and longer median hospital stay (8 days).
• Neonates showed lower rates of rash and herpangina but higher CSF protein and lower CSF glucose levels.
• The 1 month–1 year group had the highest peripheral WBC and lymphocyte counts.
• Convulsions were most frequent in the 1–3 years group (21.48%).
• >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%).

Interpretation:

HFMD shows significant age-related clinical heterogeneity, with neonatal infections following a relatively benign course and older children more prone to neurological complications.

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce bias in data collection.

Conclusion:

Age-stratified diagnostic and management strategies may facilitate early risk identification and improve clinical outcomes.