Herpangina is characterized by a sudden onset of fever, sore thoroat,
dysphagia, and characteristic lesions in the posterior pharynx.
Initial temparatures can range from normal to 41 C (106 F); fever
tends to be greater in younger patients. Headache and backache may
occur in older children, and vomiting and abdominal pain occur in
25%. Oropharyngeal lesions may be present on the anterior tonsillar
pillars, soft plalate, uvula, tonsils, posterior pharnygeal wall, and,
occasionally, the posterior buccal surfaces. Characteristic lesions are
discrete 1~2 mm vesicles and ulcers that enlarge over 2~3 days to 3~4 mm
and are surrounded by erythematous rings that vary in size up to 10 mm.
An average of 5 lesions is usually present (range, 1 to >15).
The remainder of the pharynx appears normal or minimally erythematous.
Most cases of herpangina are mild and have no complications; however,
some are associated with aseptic menigitis or other more severe illness.
Fever generally lasts 1~4 days and resolution of symptoms occurs in 3~7 days.
A variety of enteroviruses can cause herpangina, although coxsackie A
viruses are implicated most often. Some cases of herpangina have been
noted during recent outbreaks of enterovirus 71 disease.
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