Herpangina

herpangina, mild viral infection with sudden onset that is caused by several types of enteroviruses and seen most commonly in young children, generally between ages 3 and 10. The most distinctive symptom is a rash on the mucous membranes inside the mouth. The lesions in the mouth are round macules (non-raised spots) about 2 mm (0.1 inch) in diameter, occurring predominantly on the soft palate and tonsils. Herpangina is related to hand, foot, and mouth disease, which is caused by some of the same viruses; the latter, however, is characterized by sores on the hands and feet in addition to the mouth and is much more common in adults, in whom it can cause severe illness.

Herpangina usually starts abruptly with fever and sore throat, followed in some cases by loss of appetite, abdominal pain, drooling, and other nonspecific symptoms. It is often confused with strep throat (pharyngitis), but, unlike strep throat, it does not respond to treatment with penicillin or other antibiotics. Rather, the infection is self-limited, resolving within one week and requiring no treatment.

Types of enteroviruses that cause herpangina include coxsackieviruses A and B, enterovirus 71, and echovirus. These viruses are worldwide in distribution and cause illness largely in the summer and fall; in the tropics, herpangina may be more evenly distributed throughout the year. The causative viruses are transmitted from person to person, especially under conditions of crowding and imperfect hygiene. School-age children and children at day-care centres are particularly susceptible when there is a lack of handwashing and children are in close contact with one another.