Herpangina in a 17-Year-Old Boy

Herpangina

By Robert P. Blereau, MD

Throat pain of 1-day's duration sent this 17-year-old boy for medical evaluation. He had no fever and no other symptoms.

Injection of the posterior palate with multiple 1- to 2-mm pustules was evident. The patient's cervical glands were enlarged but not tender. A culture of material from these lesions showed no evidence of herpes simplex virus. A diagnosis of herpangina was made.

Herpangina, caused by group A or B coxsackievirus or other enteroviruses, generally occurs in epidemics and predominantly affects younger children. Fever, headache, and body pain may accompany the sore and vesiculated throat. The differential diagnosis includes aphthous stomatitis, herpetic stomatitis, and hand-foot-and-mouth disease.

The herpangina cleared following the patient's assiduous use of mouthwash containing tetracycline and triamcinolone.