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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

The prognosis is usually excellent. This is a self-limited syndrome which resolves on its own after a week or so. Very rarely, younger patients may refuse to drink or eat and will require intravenous hydration. It is important to manage a young child's pain to prevent this from occurring. In addition, enteroviral infections can also cause viral or aseptic meningitis, but even these patients usually recover fully.

Both herpangina and hand foot and mouth (HFM) disease are caused by enteroviruses. Both cause oral blisters and ulcers. The locations of the blisters differ, with HFM lesions occurring at the front of the mouth and herpangina lesions occurring at the back of the mouth. Approximately 75% of children with HFM also develop skin lesions on the palms and soles (as the name implies), but children with herpangina rarely develop any typical rashes.

Prevention of herpangina is dependent upon good hygiene and avoidance with individuals infected with coxsackievirus. This is easier said than done, since as mentioned earlier, 50% of infected individuals remain asymptomatic. There is no vaccine.

"Non-Polio Enterovirus Infections," CDC
http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/non-polio_entero.htm

"Viral Exanthems," Dermatology Online Journal
http://dermatology.cdlib.org/93/reviews/viral/scott.html

"Herpangina," NIH
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001964

• 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.

REFERENCES:

Dyer, J.A. "Childhood Viral Exanthems." Pediatric Annals. 36.1 Jan. 2007: 21-29.

Lee, T.C. "Diseases Caused by Enterovirus 71 Infection." Ped Infect Dis J. 28.10 Oct. 2009: 904-910.