Herpangina

Herpangina
Specialty	Infectious diseases

Herpangina, also called mouth blisters, is the name of a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A, but it can also be caused by coxsackievirus B or echoviruses. It is most common in children, and very contagious. Though herpangina can be asymptomatic, symptoms usually associated are high fever and sore throat.

A small number of lesions (usually 2 - 6) form in the back area of the mouth, particularly the soft palate or tonsillar pillars. The lesions progress initially from red macules to vesicles and lastly to ulcerations which can be 2 - 4 mm in size. The lesions heal in 7 - 10 days.

Histologically, the epithelial cells show signs of intracelular and intercellular edema. A diagnosis can be made from clinical signs and symptoms, and treatment consists of minimizing the discomfort of symptoms. Aspirin is avoided.

Etymology

The term is derived from herp, an itching, and angina, a sore throat, literally "a choking."

Clinical features

• Most commonly affects infants and young children
• Typically occurs during the summer
• Typically spreads via the fecal-oral route or via the respiratory droplets

Symptoms

• Mild and short in duration (no more than 1 week)
• Sore throat and difficulty swallowing
• Mild fever
• Referred ear pain, especially when swallowing
• Small vesicular or punctuate lesions with white base on posterior soft palate near uvula and anterior fauces of the tonsils.

Treatment

Treatment is supportive only, as the disease is self-limiting and usually runs its course in less than a week.

Sources

• Herpangina
• Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.