Herpangina is a viral illness that primarily affects young children, characterized by the sudden onset of painful sores in the mouth and throat. It is most frequently caused by coxsackieviruses, members of the enterovirus family. This condition is generally self-limiting, meaning it resolves on its own without specific medical treatment. While usually mild, herpangina can cause significant discomfort due to the oral lesions.
Understanding Its Appearance
The most distinctive feature of herpangina is the characteristic lesions that develop inside the mouth and throat. These sores appear predominantly in the back of the throat, including the soft palate, tonsils, and uvula. Initially, these manifest as small, reddish spots that emerge within hours to a day after the onset of other symptoms.
These red spots quickly progress, transforming into fluid-filled blisters, known as vesicles. These vesicles are small, measuring between 1 and 5 millimeters in diameter. Within a day or two, these blisters rupture.
Upon rupturing, the blisters leave behind shallow, grayish ulcers. These ulcers are characterized by their distinct red borders, which can be quite painful. The number of these lesions can vary, but individuals develop a few to a dozen sores. The mouth, throat, and skin appear otherwise normal.
Other Common Indicators
Beyond the visible sores, herpangina presents with several other indicators. A sudden and high fever is a common initial symptom, often preceding the appearance of mouth sores. This fever can reach temperatures as high as 106°F (41°C).
Accompanying the fever and oral lesions is a significant sore throat, which can cause considerable pain, particularly in the back of the throat. This discomfort leads to difficulty swallowing, a symptom known as dysphagia. Due to the pain associated with eating and drinking, individuals, especially young children, may experience a loss of appetite.
General feelings of unwellness, such as headache and body aches, are also common. In younger children, increased irritability or fussiness can be a behavioral sign of the illness. Drooling may also occur, particularly in infants and toddlers, as a result of the pain and difficulty swallowing saliva.
Distinguishing Herpangina from Similar Conditions
Differentiating herpangina from other conditions with oral sores or similar symptoms is important. Hand, Foot, and Mouth Disease (HFMD), also caused by enteroviruses, shares some similarities with herpangina, including fever and mouth sores. However, a distinction lies in the location of the lesions. While herpangina primarily affects the back of the throat, HFMD presents with sores on the hands, feet, and the front of the mouth or tongue.
Strep throat is a bacterial infection that can also cause a sore throat and fever, leading to potential confusion. Unlike herpangina, strep throat is not characterized by blister-like lesions and ulcers. Instead, strep throat involves redness and inflammation in the back of the throat, with white patches or streaks of pus on the tonsils. A cough is absent with strep throat, which helps distinguish it from viral infections.
Canker sores, also known as aphthous ulcers, are another type of mouth sore that can be mistaken for herpangina. Canker sores are isolated, appear anywhere in the mouth, and are not associated with fever or other systemic symptoms. They are not contagious and do not progress from red spots to blisters as seen with herpangina.
Seeking Medical Advice
While herpangina is a mild illness, certain signs warrant medical consultation. A persistent high fever, especially one that does not subside after several days or reaches high temperatures, should prompt a healthcare visit. Signs of dehydration, such as reduced urination, a dry mouth, sunken eyes, or unusual lethargy, particularly in infants and young children, warrant medical attention.
If the sore throat becomes severe or if the individual, especially a child, refuses to drink or eat due to pain, professional advice should be sought. Unexplained drowsiness or heightened irritability, beyond what is expected for a child with a fever, are also reasons to contact a healthcare provider. A medical professional can confirm the diagnosis and rule out other conditions, ensuring appropriate care.