A case of acute neurogenic pul monary edema caused by hand , f oot and mouth disease was reported in this paper . The chil d presented with f ever and characteristic  ashes in hands , f eet , mouth and buttocks . Respiratory difficulties , serious hypertension, pulmonary edema, and intracranial pressure were secondary to fever and rashes , complicated with peripheral circulatory failure . Intubation , positive pressure ventilation , high-dose intravenous γ-globulin , and short-term high-dose cortin were effective measures to prevent disease progression. After administration of mannitol and glycerol and fructose , pul monary edema and intracranial pressure were controlled. Furthermore , in combination with nutrition of myocardiumby creatine phosphate and antiviral therapy by ribavirin, the child was rescued.