Herpangina

thumb|150px|Herpangina

thumb|150px|Ulcerative herpangina

Herpangina is an infectious enanthemous disease caused by the Coxsackie viruses A (types 1–10, 16, 22) or B (types 1–5). It typically occurs in the summer months and mainly affects older children and adolescents.

Epidemiology
The route of transmission is fecal-oral (unwashed hands contaminated with feces) or respiratory tract secretions.

Incubation period is 1-10 days. Permanent immunity to a specific type of virus develops after the disease, but since there are over 20 types of coxsackieviruses, recurrence of infection with another type of virus is possible.

Clinical picture
After the incubation period, there is a sudden febrile (up to 40 °C), non-specific symptoms such as fatigue, loss of appetite and headaches. This is accompanied by a sore throat and difficulty swallowing. Grey-white vesicles appear on the soft palate, uvula and tonsils, which turn into small ulcers with a red border. There is diffuse erythema on the back wall of the pharynx. The lymph nodes may or may not be enlarged. The lesions heal without complications within 4-6 days.

Differential diagnosis

 * Gingivostomatitis herpetica – unlike gingivostomatitis, the manifestations of herpangina do not occur on the gums and usually not even on the hard palate ,
 * thrush (thrush).

Therapy
Treatment is symptomatic (mouth rinses, analgesics).