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Herpangina

Definition

Herpangina is a viral illness in which ulcers and sores (lesions) form inside the mouth, and there is a sore throat and fever.

See also: Hand, foot, and mouth disease

Causes, incidence, and risk factors

Herpangina is typically caused by Coxsackie group A viruses.

The number of cases of herpangina is unknown, but it is a common childhood infection. It is most often seen in children ages 3 - 10, but it can occur in any age group. Cases of herpangina at school or in the neighborhood increase the chances that your child will develop the illness.

Symptoms

  • Fever
  • Headache
  • Loss of appetite
  • Sore throat, or painful swallowing
  • Ulcers in the mouth and throat, and similar sores on the feet, hands, and buttocks

The ulcers usually have a white to whitish-gray base and a red border. They may be very painful. Generally, there are only a few sores.

Signs and tests

Tests are not normally necessary. Diagnosis can usually be made from the history and physical examination.

Treatment

The symptoms are treated as necessary:

  • Take acetaminophen (Tylenol) or ibuprofen (Motrin) by mouth for fever and discomfort as the doctor recommends.
  • Increase fluid intake, especially cold milk products. Gargle with cool water or try eating popsicles. Avoid hot beverages and citrus fruits.
  • Eat a non-irritating diet. (Cold milk products, including ice cream, are often the best choices during herpangina infection. Fruit juices are too acidic and tend to irritate the mouth sores.) Avoid spicy, fried, or hot foods.
  • Use topical anesthetics for the mouth (these may contain benzocaine or xylocaine and are usually not required).

Expectations (prognosis)

The illness normally clears up within a week.

Complications

Dehydration is the most common complication, but it can be treated by your doctor.

Calling your health care provider

Call your health care provider if:

  • Fever, sore throat, or mouth sores last for more than 5 days
  • Your child is having trouble drinking liquids or looks dehydrated
  • Fever becomes very high or does not go away

Prevention

Coxsackie virus is transmitted by contamination with feces, which means you can catch the virus by touching your mouth or eating without thoroughly washing your hands. Good handwashing practices can help prevent transmitting most viruses.

Being aware of other cases of herpangina in your neighborhood or school may allow earlier diagnosis.

References

Abzug MJ. Nonpolio enteroviruses. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 247.


Review Date: 11/2/2009
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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