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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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In this Article

• What is herpangina?
• What causes herpangina?
• What are herpangina symptoms and signs?
• How is herpangina diagnosed?
• What is the treatment for herpangina?
• What is the prognosis for herpangina?
• What is the difference between herpangina and hand foot and mouth disease?
• Can herpangina be prevented?
• Where can people find more information about herpangina?
• Herpangina At A Glance
• Find a local Doctor in your town
• Herpangina Index

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.

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 collected 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.

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.