Herpangina: Symptoms, Causes, Treatment

What are the symptoms of herpangina?

Herpangina is a viral illness most commonly caused by coxsackieviruses. It primarily affects children and is characterized by the following symptoms:

1. Fever: Sudden onset of high fever, often reaching up to 104°F (40°C).
2. Sore Throat: Severe throat pain and discomfort.
3. Headache: Commonly accompanies the fever and sore throat.
4. Loss of Appetite: Reduced desire to eat due to throat pain.
5. Mouth Sores: Painful red spots that develop into ulcers, usually located at the back of the mouth, particularly on the soft palate and tonsils.
6. Difficulty Swallowing: Due to the sores and throat pain.
7. General Malaise: Feeling of overall weakness and discomfort.
8. Abdominal Pain: Occasionally, children may experience stomach pain.

The symptoms typically resolve within 7 to 10 days without any specific treatment, other than supportive care to manage pain and fever. If the symptoms are severe or if dehydration is a concern due to difficulty swallowing, medical attention may be necessary.

What are the causes of herpangina?

Herpangina is primarily caused by several types of enteroviruses, most commonly the Coxsackievirus group A. Here are the main causes:

1. Coxsackievirus A: The most common cause of herpangina. This group includes many different serotypes, but A16 and A6 are among the most frequently associated with the condition.
2. Coxsackievirus B: Less commonly, Coxsackievirus B can also cause herpangina.
3. Echovirus: Some types of echoviruses can lead to herpangina.
4. Enterovirus 71: Another enterovirus that can occasionally cause herpangina.

These viruses are highly contagious and are transmitted through:

1. Fecal-oral route: Contact with contaminated hands, surfaces, or objects, especially in settings like daycares and schools.
2. Respiratory droplets: Spread through coughing or sneezing.
3. Direct contact: Touching blisters or sores of an infected person.

Herpangina most frequently occurs in children, particularly during the summer and early fall, but can occasionally affect adults.

How is the diagnosis of herpangina made?

The diagnosis of herpangina is typically made based on clinical evaluation, including a detailed medical history and physical examination. Here are the key steps involved:

1. Medical History: The healthcare provider will ask about the onset and nature of symptoms, including fever, sore throat, headache, loss of appetite, and the presence of mouth sores.
2. Physical Examination: The provider will examine the patient’s mouth and throat for characteristic signs of herpangina, such as small, red spots that develop into ulcers, primarily located on the soft palate, tonsils, and back of the throat.
3. Symptom Pattern: The combination of sudden high fever, painful ulcers in the mouth, and sore throat, especially in a child during the summer or early fall, strongly suggests herpangina.
4. Exclusion of Other Conditions: The provider may rule out other conditions with similar symptoms, such as hand-foot-and-mouth disease, strep throat, or herpetic gingivostomatitis, by noting the specific location and appearance of the ulcers.
5. Laboratory Tests: Although not usually necessary for diagnosis, laboratory tests can confirm the presence of enteroviruses:

• Throat Swab or Stool Sample: To identify the specific virus causing the infection through viral culture or polymerase chain reaction (PCR) testing.
• Blood Tests: In rare cases, blood tests may be performed to detect antibodies against the virus.

In most cases, the characteristic symptoms and clinical signs are sufficient for a healthcare provider to diagnose herpangina without the need for extensive testing.

What is the treatment for herpangina?

Herpangina is a self-limiting illness, which means that it usually resolves on its own without treatment. However, there are some treatments that can help alleviate symptoms and reduce the duration of the illness.

The main goal of treatment for herpangina is to manage symptoms, such as fever, pain, and discomfort. Here are some common treatments used to manage herpangina:

1. Pain relief:
   • Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce fever and alleviate pain and discomfort.
   • Topical anesthetics, such as Orajel or Anbesol, can be applied to the affected areas to numb the pain.
2. Fever reduction:
   • Antipyretics, such as acetaminophen or ibuprofen, can help reduce fever.
   • Cold compresses or a cool mist humidifier can also help bring down a fever.
3. Soothing agents:
   • Aloe vera gel or other soothing topical creams can help calm irritated skin.
   • Salt water rinses or salt water gargles can help soothe the throat.
4. Antibiotics:
   • Antibiotics are not typically prescribed for herpangina, as it is caused by a viral infection. However, if the infection spreads to the throat or other areas of the body, antibiotics may be prescribed.
5. Rest and hydration:
   • Resting and staying hydrated with plenty of fluids can help the body recover from the infection.
6. Throat lozenges:
   • Throat lozenges containing ingredients like menthol, phenol, or benzocaine can help soothe a sore throat.
7. Topical antivirals:
   • Topical antiviral creams or ointments may be prescribed to speed up the healing process and reduce the severity of symptoms.

It’s important to note that antiviral medications are not effective against herpangina, as it is caused by a viral infection. Treatment is mainly focused on managing symptoms and promoting comfort.

If you suspect you or your child has herpangina, it’s essential to consult with a healthcare provider for proper diagnosis and treatment. They may recommend additional measures to alleviate symptoms and prevent complications.