Herpangina is a common and painful mouth infection. Though it can affect adults and adolescents, it primarily develops in young children and infants. Four enteroviruses, which usually affect the gastrointestinal tract, can lead to herpangina. Like many viral infections, herpangina is contagious and spreads easily. Most cases are not serious and do not require medical attention. However, a herpangina infection can lead to dangerous complications.
Though herpangina can have a variety of symptoms, the most common is the growth of small blisters. Typically, four or five blisters appear along the roof and back of the mouth within a couple of days of exposure to the virus. These small pockets of fluid are light gray with red borders and are often extremely painful. As the infection progresses, the blisters become shallow ulcers.
In addition to blisters, herpangina can cause a fever, sore throat, swollen lymph nodes, and headaches. Fevers often develop suddenly and may reach frighteningly high temperatures. Very large blisters can make it difficult to swallow, which can, in turn, inhibit appetite. If blisters grow in the throat, they may cause general neck pain. Infants with herpangina tend to drool more and may even vomit.
Most cases of herpangina resolve themselves within a week or ten days. However, sometimes the infection worsens, and an individual develops dangerous complications that require medical attention. The most common complication of herpangina is dehydration, the signs of which include dry mouth, fatigue, and sunken eyes. The person may also have dark urine and reduced urine output. Mouth sores that last for longer than five days are usually a sign of a serious issue. If the fever that accompanies herpangina reaches 106 degrees F or does not go away, immediately seek medical care. Vomiting or diarrhea for longer than a day is also serious.
One of four viruses causes herpangina: Coxsackievirus A, Coxsackievirus B, enterovirus 71, and echovirus. Infections involving these viruses are contagious and spread easily, especially between children, who tend to catch herpangina from contact with respiratory droplets from sneezes or coughs. Herpangina may also occur after contact with fecal matter. Like many viruses, herpangina is resilient and can survive outside the body for several days.
Specific factors increase the likelihood of a person developing herpangina. The virus most commonly affects children between three and ten. Herpangina infections are also significantly more likely to occur during the summer and early fall in the United States, though tropical climates may see cases year-round. Children who spend significant time in schools, summer camps, or childcare facilities are more likely to develop infections, as are those who do not wash their hands regularly.
Most physicians find it easy to diagnose herpangina because of the signature mouth blisters. Though the infection is similar to several other enterovirus infections, the location of the ulcers helps with the diagnosis. If a doctor is unsure about a diagnosis, they may inquire as to other symptoms, such as fever, dehydration, or neck pain. Special diagnostic tests are rarely necessary.
Herpangina primarily affects young children because most adults built up natural immunities to enough viruses as they matured. Following the infection, children will usually become immune to future attacks of herpangina viruses. Most adults who develop the infection lack immunity and live in close contact with an infected individual. Men and women who reside in group living situations such as military barracks have slightly higher instances of infection. Pregnant women are significantly more likely to experience complications.
Infant herpangina can be extremely dangerous. Many babies show no symptoms or only those difficult to notice. Additionally, babies are more at risk of complications such as liver failure, swelling of the brain, or infection of the meninges, essential membranes that cover the spinal cord and brain. It is very rare for herpangina to be lethal, but the majority of fatal cases occur in babies under one year.
Because herpangina usually resolves itself in a matter of days, doctors may not treat it directly. Instead, their primary goal is managing blisters and pain. Specific treatment plans are dependant on the patient’s age and symptoms. Antibiotics are ineffective against viral infections, and there is no antivirus for herpangina. Home treatment options include increasing fluid intake and dietary changes. Avoiding spicy, salty, or acidic foods can help reduce the pain of herpangina.
Since there is no direct treatment for herpangina, the best option is prevention. Good hygiene is one way to protect against the infection. Frequent and thorough hand washing can prevent the spread of viruses. It’s also important for children to cover their mouths and noses when sneezing or coughing. Cleaning and disinfecting countertops, tables, bathrooms, and toys will destroy the virus and stop it from spreading.
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