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General Medicine

Herpangina

David Cole, MD, Munima Nasir, MD and Jarrett Sell, MD, AAHIVS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Highly infectious viral disease caused most commonly by coxsackievirus and other enterovirus species (1)

  • Characteristics:

    • Fever of short duration (<5 days)

    • Characterized by painful v...

DIAGNOSIS

HISTORY

  • Fever of relatively sudden onset

  • General malaise, anorexia, irritability, listlessness

  • Sore throat, drooling, coryza

  • Neck pain, headache, back pain

  • Diarrhea

PHYSICAL EXAM

  • Characterized orop...

TREATMENT

Benign, self-limited course. Symptoms typically abate in less than a week. 

GENERAL MEASURES

  • Self-limited

  • Palliative and supportive care; emphasize hydration.

MEDICATION

First Line

  • Analgesics

    • Aceta...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • No restrictions

  • As tolerated, with no limitations

Patient Monitoring

Hydration 

DIET

  • Clear liquids

  • Cold beverages, milk, and ice cream are soothing. Hot, acidic beverag...

REFERENCES

1
Park SH, Choi SS, Oh SA, et al. Detection and characterization of enterovirus associated with herpangina and hand, foot, and mouth disease in Seoul, Korea. Clin Lab.  2011;57(11–12):9...

SEE ALSO

Herpes Simplex 

CODES

ICD10

B08.5 Enteroviral vesicular pharyngitis 

ICD9

074.0 Herpangina 

SNOMED

186659004 Herpangina 

CLINICAL PEARLS

  • Herpangina occurs most commonly during summer months in children.

  • Coxsackievirus and other enterovirus are the most common causes of herpangina.

  • Proper hand hygiene protects against spre...

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FIG. 11.8. Coxsackie hand-foot-and-mouth disease. A: A hand and a foot of this child show isolated vesicles compared with the grouped vesicles seen in the patient in Figure 11.7 with a herpetic infection. The child also had palatal lesions. B: Scattered petechiae appear centrally, and there is a vesicle posteriorly at the junction of the hard and soft palates. Coxsackievirus produces lesions toward the posterior of the oropharynx, whereas herpes simplex virus appears anteriorly.
FIG. 11.8. Coxsackie hand-foot-and-mouth disease. A: A hand and a foot of this child show isolated vesicles compared with the grouped vesic...
FIG. 11.8. Coxsackie hand-foot-and-mouth disease. A: A hand and a foot of this child show isolated vesicles compared with the grouped vesicles seen in the patient in Figure 11.7 with a herpetic infection. The child also had palatal lesions. B: Scattered petechiae appear centrally, and there is a vesicle posteriorly at the junction of the hard and soft palates. Coxsackievirus produces lesions toward the posterior of the oropharynx, whereas herpes simplex virus appears anteriorly.
FIG. 11.8. Coxsackie hand-foot-and-mouth disease. A: A hand and a foot of this child show isolated vesicles compared with the grouped vesic...
Figure 20-2 Herpangina. (Courtesy of Paul S. Matz, MD.)
Figure 20-2 Herpangina. (Courtesy of Paul S. Matz, MD.)
Figure 26-3 Herpangina. (Courtesy of Philip Siu, MD.)
Figure 26-3 Herpangina. (Courtesy of Philip Siu, MD.)
herpangina
herpangina
Hand-foot-mouth disease in a young child with fever and irritability
Hand-foot-mouth disease in a young child with fever and irritability
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