Herpangina is a childhood illness characterized by painful sores or ulcers in the mouth, lips, throat and palate. It is caused by several viruses, most notably the coxsackie virus and echovirus, which belong to the family of the enteroviruses. It is a self-resolving illness that can cause significant pain and discomfort to a child.
Time Frame
According to the Merck Manuals Online Medical Library, herpangina tends to occur in epidemics among children between 1 and 4 years of age. It is most common in the late summer and fall months, and spreads rapidly among children in close settings such as school or day care. The virus is present in the stool and in respiratory droplets, which can carry the virus when an infected child coughs or sneezes.
Symptoms
Patients with herpangina experience sudden onset of fever, sore throat with difficulty swallowing, headache and neck pain. According to the Children's Hospital of Boston, the fever can be as high as 106 degrees Fahrenheit. Children with herpangina have significant pain in their mouths and throat, which causes a decrease in appetite, drooling and dehydration.
Identification
The hallmark of herpangina is the vesicles that from about two days after the onset of fever. These vesicles have a red inflamed base, and can eventually erode and form ulcers. They occur most often on the tonsils, the tongue and the palate. The vesicles can last up to a week before starting to heal.
Complications
The main complication of herpangina is dehydration. Children with herpangina refuse to ingest any kind of food or liquid because of the pain in the back of their throats. The inability to tolerate liquids results in decreased urine output, dried lips, lack of tears when crying and decreased level of activity, all signs of dehydration. Occasionally, the rapid onset of fever can cause a febrile seizure.
Treatment
The treatment for herpangina is supportive. This includes control of the fever and pain with over-the-counter medicines, such as acetaminophen and ibuprofen. Intravenous fluids may be necessary to manage hydration if the child is unable to tolerate liquids by mouth and if she is severely dehydrated
