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Herpangina - Causes, Symptoms and Treatment

What is Herpangina?

Herpangina is an acute viral infection which typically produces vesicular lesions on the mucous membranes of the soft palate, tonsillar pillars, and throat. Herpangina usually affects children under age 10 (except newborns because of maternal antibodies), and generally subsides in 4 to 7 days. It's slightly more common in late summer and fall, and can be sporadic, endemic, or epidemic.

What are the Causes of Herpangina?

Herpangina is caused by group A coxsackieviruses (usually types 1 through 10, 16, and 23) and, less commonly, by group B coxsackieviruses and echoviruses. The main mode of transmission of herpangina is fecal-oral transfer.

What are the Signs and Symptoms of Herpangina?

After a 2- to 9-day incubation period, herpangina begins abruptly with a sore throat, pain on swallowing, a temperature of 100° to 104° F (37.8° to 40° C) that persists for 1 to 4 days and may cause seizures, headache, anorexia, vomiting, malaise, diarrhea, and pain in the stomach, back of the neck, legs, and arms. After this, up to 12 grayish white papulovesicles appear on the soft palate and, less commonly, on the tonsils, uvula, tongue, and larynx. These lesions grow from 1 to 2 mm in diameter to large, punched-out ulcers surrounded by small, inflamed margins.

Diagnosis for Herpangina

Characteristic oral lesions suggest this diagnosis; isolation of the virus from mouth washings or feces, and elevated specific antibody titer confirm it. Other routine test results are normal except for slight leukocytosis. Diagnosis requires distinguishing the mouth lesions in herpangina from those in streptococcal tonsillitis (no ulcers; lesions confined to tonsils).

Treatment for Herpangina

Treatment for herpangina is entirely symptomatic, emphasizing measures to reduce fever and prevent seizures and possible dehydration. Herpangina doesn't require isolation or hospitalization but does require careful hand washing and sanitary disposal of excretions.

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