Herpangina

The Herpangina is a fairly common disease with very similar external characteristics of a sore throat caused by a flu . However, the difference is that herpangina is caused by the Coxsackie virus , responsible in other cases of meningitis, stomatitis and conjunctivitis. Its name is derived from the fact that there are some external manifestations such as abundant eruptions of transparent bubbles in the mouth and throat, very similar to those that appear when you have herpes. However, it should be noted that herpes is not responsible for the development of herpangina.

Definition

Herpangina is a viral infection that causes sores and lesions in the mouth . Although it is more common in children, the virus can affect people of any age. This disease is transmitted by saliva or by contact with the feces of an infected person due to poor hygiene conditions.

Herpangina characteristics

• Herpangina is normally transmitted by saliva , by mouth-to-mouth contact, or by contact with the feces of an infected person.
• The virus can take about 6 days to show symptoms after being contracted.
• A sore throat is characterized by being so unpleasant that consuming solid foods can be extremely painful.
• The lesions that appear in the oral cavity are white and have a red border.

Herpangina in children and adults

Herpangina is a disease especially associated with children under 10 years of age . It is a painful condition that can make children not want to eat anything during the days of the illness. Many adults are carriers of the virus and thus in the first years of life, the child could be in contact with someone who carries the virus.

Also, herpangina can occur in adults due to a weakening of the immune system.

Causes

Although the term herpangina may lead you to believe that herpangina is caused by the herpes virus, it is actually transmitted by the Coxsackie virus type A in most cases.

This virus is caused by simple contact or by inhalation (a sneeze for example). The risk of infection is quite high in children , especially during the summer season. Indeed, the peak frequency of the disease extends from June to September.

Symptoms

Herpangina is characterized by the brutal onset of a fever with angina and often sore throats . Young children can vomit.

In the 2 days after the beginning of the infection, up to 20 papules or grayish lesions of 1 to 2 milliliters in diameter may appear that evolve until they are surrounded by an erythematous aureole. They usually appear on the tonsils and also on the soft palate or tongue. In the next 24 hours, the lesions develop into shallow ulcerations that can be as large as 5 millimeters in diameter. These heal in 1 to 7 days.

Other symptoms that may appear due to herpangina are the following:

• Stomach aches, nausea, and diarrhea . In children, diarrhea can be so severe that it can be a real danger of severe dehydration of the body. Adults, on the other hand, can often feel severe stomach and intestinal pain as well as muscle aches.
• Enlargement and swelling of the lymph nodes , especially in the head and neck region.

Diagnosis

The diagnosis of herpangina is based mainly on the physical evaluation of the patient , on the symptoms that he presents and on the characteristic oral lesions. Thus, in general , laboratory tests are not necessary, although they can be done if the virus is to be confirmed . To do this, the most reliable thing is to  examine the patient’s blood for the presence of specific antibodies to Coxsackie viruses. Likewise, when less common diseases are suspected, a test of the fluid from one of the lesions present in the oral cavity is performed.

At the beginning of the virus, herpangina can be confused with other diseases , especially when the patient has a strong immunity and does not present complete symptoms of the disease.

Herpangina treatment

As it is a disease that mainly affects children, here are some indications about the treatment that they should follow during the manifestation of the virus.

Herpangina treatment consists of offering care to the child by ensuring that he or she remains hydrated and is as comfortable as possible despite the discomfort caused by the symptoms. This will help your body fight the infection.

For pain relief, your child may be given acetaminophen or ibuprofen under medical indications . Rectal suppositories can be used if the child cannot take oral medications.

It should be noted, that antibiotics have no effect on the virus and will not cure the disease. However, if a bacterial complication arises, antibiotics can be given.

Regarding food, it is important to encourage the child to drink liquids in small quantities . Cold, bland foods like ice cream or compote are soothing and won’t irritate you. Dairy products are also recommended. In contrast, citrus fruits, soda or hot drinks, and salty or spicy foods can cause more irritation to the mouth.

Duration

Herpangina occurs in an interval between one week and ten days . The lesions disappear on their own. The individual is then immune to group A Coxsackie virus. During this time, pain relievers are prescribed to the patient to make the wait for spontaneous cure less unpleasant.

Complications

The possible complications caused by herpangina constitute the main reason for the use of therapeutic methods to treat the disease since the disease as such is tolerated by the body normally.

Complications that can occur from herpangina include the following:

• The dehydration . In the case of children, they feel so much pain to swallow that they prefer not to eat or drink anything. Therefore, it is important to follow up and ensure that they ingest at least fluids.
• Kernig syndrome .
• Its main danger is that it does not give many external signs and can only be diagnosed through a cardiogram. Without treatment, it can often develop into a chronic condition and can cause serious heart problems later in life.
• Injury to the liver .
• Necrosis of muscle tissue . This complication is very rare, it occurs especially when herpangina is severe.

Herpangina during pregnancy

According to some studies, when a woman is infected with the herpangina virus during pregnancy, this factor can have consequences for the baby such as small size for gestational age and low birth weight . Likewise, premature birth has been associated as a possible consequence of acquiring the virus during pregnancy.

However, if the mother of the child was infected with the virus before pregnancy, the child retains the innate immunity that it receives from its mother. This immunity is sufficient for several months and then if it comes into contact several times with an active carrier of the virus, the child is infected.

Prevention

Coxsackie viruses and other herpangina viruses are transmitted by contaminated fecal matter, so you can be infected if you eat with your hands or if you put your hands in your mouth without washing them. In that sense, a preventive measure would be to wash your hands , not only for herpangina but also for most viruses.