Disease: 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 causes herpangina?

    Several common Coxsackie A viruses can cause herpangina, although a number of other enteroviruses have also been implicated. The viruses are usually spread via the "fecal-oral route" or via "respiratory route." Contact with mucous of an individual infected with one of these viruses is usually all that is needed to contract the illness. The normal course of the infection involves an incubation period which is generally an asymptomatic period lasting anywhere from one to two weeks. In fact, half of individuals infected with some of these enteroviruses remain asymptomatic throughout, which makes preventing transmission more difficult.

    What are herpangina symptoms and signs?

    Typically children with herpangina have the following:

    • Fever
    • Sore throat
    • Small blisters and ulcers may cover the soft palate, uvula, tonsils, and posterior pharynx. The rest of the mouth is normal appearing. These blisters can last for up to a week.
    • Enlarged lymph nodes along the neck (lymphadenopathy)
    • Rash may or may not be present.

    How is herpangina diagnosed?

    Since herpangina is a clinical diagnosis, and self-limited, there is no real reason to perform any laboratory studies. Some children (hospitalized or immune-compromised for example) may have viral studies performed on specimins from the nose or throat. Isolating virus from these samples takes a long time and generally symptoms will be resolved long before the identification of the virus is available. Antibodies to coxsackievirus may also be measured if desired.

    What is the treatment 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.

    Learn more about: Tylenol

    What are herpangina symptoms and signs?

    Typically children with herpangina have the following:

    • Fever
    • Sore throat
    • Small blisters and ulcers may cover the soft palate, uvula, tonsils, and posterior pharynx. The rest of the mouth is normal appearing. These blisters can last for up to a week.
    • Enlarged lymph nodes along the neck (lymphadenopathy)
    • Rash may or may not be present.

    How is herpangina diagnosed?

    Since herpangina is a clinical diagnosis, and self-limited, there is no real reason to perform any laboratory studies. Some children (hospitalized or immune-compromised for example) may have viral studies performed on specimins from the nose or throat. Isolating virus from these samples takes a long time and generally symptoms will be resolved long before the identification of the virus is available. Antibodies to coxsackievirus may also be measured if desired.

    What is the treatment 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.

    Learn more about: Tylenol

    Source: http://www.rxlist.com

    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.

    Source: http://www.rxlist.com

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