About herpangina

What is herpangina?

Herpangina facts

  • Herpangina is a self-limited infection primarily caused by coxsackieviruses.
  • Herpangina most often affects young children.
  • Herpangina is associated with fever, sore throat, and blisters in the back of the mouth.
  • Herpangina is diagnosed based on clinical symptoms alone.
  • Treatment of herpangina is usually directed toward minimizing the discomfort associated with the mouth blisters.
  • Most children with herpangina recover completely after four to seven days.
  • There is no easy way to prevent herpangina.

What is herpangina?

Herpangina is an acute, virally induced, self-limited illness often seen in young children during the summer months. Affected children usually complain of mouth sores and fever. It is caused by a number of viruses, all part of the enterovirus family, coxsackievirus being the most common. Most children develop a high fever and complain of a sore throat. They then develop vesicles (blisters) or ulcers (sores) at the back of the throat and palate (called an enanthem). Children, especially younger children, may refuse to eat or drink because of the pain and are at risk for developing signs and symptoms of dehydration.

What are the symptoms for herpangina?

Symptoms of herpangina can vary depending on which virus causes the infection. Some children with herpangina don’t have any symptoms. ‌

Herpangina usually shows up two to five days after you’ve been exposed to the virus. Symptoms include:

  • White blister-like bumps in the back of the throat or on the roof of the mouth, tonsils, uvula, or tongue
  • Sudden fever
  • High fever
  • Sore throat
  • Headache
  • Neck pain
  • Loss of appetite
  • Drooling
  • Fussiness
  • Dehydration‌

Depending on the type of virus, some children also have symptoms like throwing up, muscle weakness, and trouble breathing. Older children might also have back pain.

Fevers tend to last 3 to 6 days and are sometimes very high. Rarely, this can cause a seizure called a febrile seizure. 

What are the causes for herpangina?

Herpangina is caused by a virus. The most common viruses responsible include:

  • Coxsackie B 
  • Coxsackie A16 
  • Enterovirus 71
  • Echovirus‌

Herpangina is spread through respiratory droplets, saliva, directly touching fluid from a sore, or through stool. You can get the virus from someone who is sick with herpangina and coughs, sneezes, shouts, or sings near you. 

What are the treatments for herpangina?

Treatment is supportive, just like for most viruses. Fever control and pain control with antipyretics, such as acetaminophen (Tylenol) or ibuprofen (Advil) is generally the primary treatment. It is important to keep children well hydrated as well, and often young children will be resistant to drinking or eating. The aptly named "magic mouthwash" is an alternative treatment used to control the mouth pain associated with herpangina. There are various recipes, but most include a topical pain medication such as viscous lidocaine as well as some sort of additional liquids which function as a barrier. Your child's health-care provider might prescribe one of these. It is important to remember that these types of medications should always be used as directed by your provider, since some of the components may have serious side effects if given in too high a concentration. Remember that since herpangina is caused by a virus, antibiotics have no role in the treatment, nor do any antiviral medications currently available.

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