Herpangina - Tonsil Ulcers

- September 17, 2017

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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) but it can also be caused by coxsackievirus B or echoviruses. Most cases of herpangina occur in the summer, affecting mostly children. However, it occasionally occurs in adolescents and adults. It was first characterized in 1920.


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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 with red surrounds, and over 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.

A small number of lesions (usually 2 - 6) 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.


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Cause

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


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Pathophysiology

Histologically, the epithelial cells show signs of intracellular and extracellular edema.


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Diagnosis

A diagnosis can be made from clinical signs and symptoms, and treatment consists of minimizing the discomfort of symptoms.


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Treatment

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

No Antiviral medications exist for Coxsackie A or other Enteroviruses.


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Epidemiology

  • Most commonly affects infants and young children
  • Typically occurs during the summer

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Etymology

The term is derived from the Greek herp, creeping, snake like, and Latin angina, quinsy, literally "inflammation or swelling of the throat or part of the throat, esp. tonsillitis".

Source of the article : Wikipedia



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