Herpangina

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Herpangina
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An example of herpangina in a child
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Herpangina, also called mouth blisters, is a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term "herpangina virus" refers to coxsackievirus A), [1] but it can also be caused by coxsackievirus B or echoviruses. [2] Most cases of herpangina occur in the summer, [3] affecting mostly children. However, it occasionally occurs in adolescents and adults. It was first characterized in 1920. [4]

Contents

Signs and symptoms

Symptoms include sudden fever with sore throat, headache, loss of appetite, and often neck pain. Within two days of onset, an average of four or five (but sometimes up to twenty) 1 to 2 mm diameter grayish lumps form and develop into vesicles surrounded by redness. Over the next 24 hours, these become shallow ulcers, rarely larger than 5 mm diameter that heal in one to seven days. These lesions most often appear on the tonsillar pillars (adjacent to the tonsils), but also on the soft palate, tonsils, uvula, or tongue. [5]

A small number of lesions (usually two to six) form in the back area of the mouth, particularly the soft palate or tonsillar pillars. The lesions progress initially from red macules to vesicles and lastly to ulcerations, which can be 2–4 mm in size. [6]

Cause

Typically spreads via the fecal-oral route or via respiratory droplets. [6]

Diagnosis

A diagnosis can be made from clinical signs and symptoms, and treatment consists of minimizing the discomfort of symptoms. [5] It can be differentiated from herpetic gingivostomatitis by the positioning of vesicles - in herpangina, they are typically found on the posterior oropharynx, as compared to gingivostomatitis where they are typically found on the anterior oropharynx and the mouth. [7]

Treatment

Treatment is usually supportive only, [8] as the disease is self-limiting and usually runs its course in less than a week.

In children with herpangina, using peginterferon α-2b spray may recover more quickly. [9] Silver ion Spray [10] and Albinterferon [11] may also heipful.

Epidemiology

Etymology

The term is derived from Greek herp 'creeping, snakelike' and Latin angina 'quinsy', literally "inflammation or swelling of the throat or part of the throat, esp. tonsillitis". [12] [13]

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<span class="mw-page-title-main">Pharyngitis</span> Inflammation of the back of the throat

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References

  1. "Herpangina Virus" at Dorland's Medical Dictionary
  2. "Herpangina" at Dorland's Medical Dictionary
  3. Michael I. Greenberg (2005). Greenberg's text-atlas of emergency medicine. Lippincott Williams & Wilkins. p. 156. ISBN   978-0-7817-4586-4 . Retrieved 11 April 2010.
  4. Ralph D. Feigin (2004). Textbook of pediatric infectious diseases. Elsevier Health Sciences. p. 170. ISBN   978-0-7216-9329-3 . Retrieved 11 April 2010.
  5. 1 2 "Herpangina". Merckmanuals.com. Merck. Retrieved 21 December 2014.
  6. 1 2 Yu H, Li XW, Liu QB, Deng HL, Liu G, Jiang RM, Deng JK, Ye YZ, Hao JH, Chen YH, Nong GM, Shen ZB, Liu CS, Zou YX, Wu JZ, Wu XD, Chen BQ, Luo RP, Lin AW, Chen Y, Liu XD (April 2020). "Diagnosis and treatment of herpangina: Chinese expert consensus". World J Pediatr. 16 (2): 129–134. doi:10.1007/s12519-019-00277-9. PMID   31347021.
  7. Parrot, RH; Wolf, SI; Nudelman, J; Naiden, E; Huebner, RJ; Rice, EC; McCullough, NB (August 1954). "Clinical and laboratory differentiation between herpangina and infectious (herpetic) gingivostomatitis". Pediatrics. 14 (2): 122–9. PMID   13185685.
  8. "ULCERATIVE LESIONS OF THE ORAL CAVITY". Utmb.edu. Archived from the original on 7 September 2013. Retrieved 21 December 2014.
  9. Ye, Ying-Zi; Dou, Ya-Lan; Hao, Jian-Hua; Zhou, Li; Lin, Ai-Wei; Wang, Shao-Ning; Deng, Ji-Kui; Lei, Min; Luo, Ru-Ping; Liao, Yi-Nan; Chen, Yan; Long, Yuan-Yuan; Chen, Bi-Quan; Yang, Zhi; Gan, Lu; Nong, Guang-Min; Yan, Wei-Li; Yu, Hui (June 2021). "Efficacy and safety of interferon α-2b spray for herpangina in children: A randomized, controlled trial". International Journal of Infectious Diseases. 107: 62–68. doi: 10.1016/j.ijid.2021.04.049 . PMID   3387846.
  10. Gao Haiyan, ed. (2011). "银尔通佐治小儿疱疹性咽峡炎50例临床观察[Clinical Observation on 50 Cases of Herpetic Angina Treated by Yinertong in Children]". China Medicine And Pharmacy. 13: 111–112.
  11. 甘浩东; 王丹, eds. (2024). "Analysis of the value of recombinant human interferon alb atomization inhalation in the treatment of herpetic pharyngitis in children". International Journal of Clinical Research. 8 (10). doi:10.12208/j.ijcr.20240413.
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  13. "Quinsy - Define Quinsy at Dictionary.com". Dictionary.com. Retrieved 21 December 2014.