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What is Herpangina?
Written by Medicover Team and Medically Reviewed by Dr Vempati Satya Surya Prasanthi , Pediatricians
Herpangina is a common viral illness in children, marked by sudden fever, sore throat, and painful mouth ulcers. It affects the back of the mouth and throat, making swallowing difficult. Prompt care helps relieve discomfort, prevents dehydration, and limits its spread in group settings like schools and daycares.
Herpangina is a viral infection of the throat, primarily affecting children. Enteroviruses, most commonly Coxsackievirus A, cause it. The infection leads to painful, blister-like ulcers at the back of the mouth, especially on the soft palate, tonsils, and uvula. Though uncomfortable, it is usually self-limiting and resolves within a week.
What are the Herpangina Symptoms and Warning Signs?
Herpangina symptoms appear suddenly and can be alarming due to the high fever and mouth pain. Recognizing them early can help avoid complications.
Common Symptoms of Herpangina
- High fever (100.4°F to 104°F or 38°C to 40°C)
- Sore throat
- Painful swallowing
- Headache
- Loss of appetite
- Small red blisters or ulcers in the back of the mouth
- Fussiness or irritability in infants
Severe mptoms of Herpangina (seek medical help)
- Signs of dehydration (dry lips, reduced urination, sunken eyes)
- Persistent high fever (>102.2°F or 39°C)
- Difficulty swallowing liquids
- Uncontrolled crying or discomfort in infants
What are the Common Causes and Risk Factors of Herpangina?
Herpangina is caused by enteroviruses, which spread through close contact and poor hygiene. Understanding both causes and risk factors can help with prevention.
Causes of Herpangina
- Coxsackievirus A (most frequent)
- Coxsackievirus B, Echoviruses, Enterovirus 71 (less common)
Risk Factors of Herpangina
- Age: Most common in children aged 3 to 10 years
- Group settings: Schools, daycare centers
- Poor hand hygiene
- Warmer seasons: More prevalent during summer and early fall
- Weakened immune system
Parents and caregivers should consult a doctor if symptoms develop in infants or children at high risk.
How is Herpangina Diagnosed?
Herpangina is typically diagnosed based on symptoms and a simple physical exam. Since it's a viral illness, doctors often do not need advanced tests to confirm the condition.
Physical Examination
- Check for redness and small blisters or ulcers in the back of the mouth.
- Look at the soft palate, tonsils, and uvula, which are the most affected areas.
- Measure the child's temperature and ask about symptoms such as a sore throat, poor appetite, and fever.
When are Lab Tests Used?
In most cases, lab tests are not needed. However, a doctor may suggest them if:
- The child is very young or has other health issues.
- The symptoms are not typical of herpangina.
- The illness is severe or prolonged.
Possible tests include
- Throat swab: Helps detect the virus, especially if other infections (like strep throat) need to be ruled out.
- Stool sample: May be used to identify enteroviruses.
- Blood test: Rarely done, but may be used if there are signs of complications or another diagnosis is suspected.
Doctors mainly rely on experience and visible signs, which are usually clear in children with herpangina.
What are the Treatment Options for Herpangina?
There is no cure for the virus that causes herpangina, but treatment helps ease symptoms and keep the child comfortable. Most children recover at home within a few days.
Medications for Fever and Pain Relief
- Paracetamol (acetaminophen) or ibuprofen is safe to use for children to reduce fever, throat pain, and general discomfort.
- Do not use aspirin in children, as it can lead to a serious condition called Reye's syndrome.
Oral Pain Relief
- Cold foods, such as ice cream, yoghurt, and popsicles, can help numb the throat and reduce pain.
- In some cases, doctors may prescribe a mild topical anaesthetic gel to apply directly on mouth ulcers, but this should be used carefully.
Fluids and Hydration
- Children may avoid drinking due to mouth pain, which puts them at risk of dehydration.
- Offer small sips of water, electrolyte solutions, fruit juices, or soups throughout the day.
Rest and Diet
- Encourage the child to rest at home and avoid school or daycare until the fever is gone.
- Feed soft, bland foods like mashed potatoes, bananas, or porridge.
- Avoid spicy, acidic, or salty foods, as they can exacerbate mouth pain.
In severe cases
- IV fluids may be given if the child is too dehydrated or refuses to drink.
- Monitoring may be required if fever is high or ulcers interfere with breathing or swallowing.
When to See a Doctor?
Herpangina typically resolves on its own within a week. However, in some cases, symptoms can become severe and require medical attention. Parents should watch closely and not ignore warning signs.
Seek medical attention if your child has:
- Fever higher than 39°C (102.2°F) that lasts more than 2&3 days
- Signs of dehydration like dry mouth, dark urine, no tears when crying, or reduced urination
- Refusal to drink fluids due to throat pain
- Extreme tiredness, confusion, or continuous irritability
- Difficulty breathing or swallowing
- Convulsions or febrile seizures, especially in younger children
Who is at higher risk for complications?
- Infants and toddlers under 3 years
- Children with weak immune systems
- Children who already have another illness or are on immune-suppressing medication
Timely doctor visits can help prevent serious outcomes, such as dehydration or secondary infections.
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What is the Recovery Process After Herpangina Treatment?
Most children with herpangina recover completely in 5 to 7 days. During this time, comfort and hydration are key to recovery. Parents play a crucial role in helping their children feel better and recover more quickly.
Recovery Tips at Home:
- Let the child rest and sleep more to support healing
- Give frequent fluids, water, electrolyte drinks, broths, or diluted fruit juices
- Offer cool, soft foods like yoghurt, pudding, or mashed bananas
- Avoid spicy, hot, or crunchy foods until mouth ulcers heal
After-care advice:
- Keep your child home from school or daycare until the fever is gone for at least 24 hours
- Clean toys, utensils, and frequently touched surfaces
- Encourage good hand-washing habits even after recovery
Follow-Up:
- Routine follow-up is not needed unless symptoms worsen
- See your doctor if new symptoms appear or if ulcers last more than 10 days
With good care, most children return to normal activities within a week and do not face long-term effects.
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What Precautions Can Help Prevent Herpangina?
Herpangina spreads easily, especially in children. Preventive steps at home and in group settings can lower the chance of infection and help protect others.
Prevention Tips
- Wash hands often with soap and water, especially after using the toilet or changing diapers
- Use alcohol-based hand sanitiser when soap is not available
- Avoid sharing utensils, bottles, towels, and toys
- Teach children to cover their mouth and nose when coughing or sneezing
- Disinfect commonly touched surfaces like door handles, toys, and tables
- Keep children with symptoms at home to prevent spread to others
Lifestyle Tips to Boost Immunity:
- Provide a balanced diet with fruits and vegetables
- Make sure the child gets enough sleep and rest
- Stay up to date with routine vaccinations
- Limit exposure to crowded places during outbreaks
Complications of Herpangina
Most children recover fully, but if left untreated, herpangina can lead to health issues, especially in young or immunocompromised children.
Common Complications
- Dehydration: Painful ulcers may prevent the child from drinking enough fluids
- Febrile seizures: Can occur with very high fevers in infants or toddlers
- Secondary infections: Open ulcers can rarely get infected with bacteria
- Weight loss or fatigue: Due to poor appetite and reduced fluid intake
If complications arise, early medical attention can help ensure a complete and rapid recovery.
Our Experience Treating Herpangina
At Medicover Hospitals, we recognize how stressful herpangina can be for both children and their families. Our experienced pediatricians provide a timely and accurate diagnosis based on visible symptoms and clinical expertise.
We focus on making children comfortable through personalized care plans that relieve pain, reduce fever, and ensure proper hydration. In more serious cases, we provide close monitoring and inpatient care to manage complications such as dehydration.
Our child-friendly environment helps reduce fear during visits, and we guide parents with clear instructions for home care and hygiene. From diagnosis to recovery, our team is committed to providing gentle, effective, and reassuring care every step of the way.
