Herpangina B08.5

Zahorsky, 1920; Cole, 1951

Infection of the pharynx by human enterovirus A (coxsackie virus-A) by droplet infection from person to person.

Coxsackie viruses of groups A2, A4, A5, A6, A8, A10, B4.

Worldwide occurrence, mainly in summer, leaves permanent immunity

Coxsackie virus infection.

Incubation period: 2-5 days. Acute fever increase with biphasic fever course. Influenza-catarrhal phenomena. Occurrence of glass pinhead-sized, chain-like arranged, yellowish-pink, frogspawn-like vesicles on the soft palate and the palatal arches. Transformation into smeary-coated erosions with hyperemic surroundings.

Gingivostomatitis herpetica: acute course, affects young children (up to 5 years).

Angina plaut-Vincenti: Acute ulcerative tonsillitis due to mixed infection with Treponema vincenti (see spirochetes below), Fusobacterium plauti and other spirochetes, Bacteroides species.

Diphtheria: Whitish, fibrinous, pseudomembranous, firmly adherent, sweet foul smelling coatings on the tonsils, palatal arches and uvula in diphtheria.

Candidiasis: more subacute to chronic course. Two-dimensional whitish coatings.

Symptomatic. Rinse with wound-healing or astringent pharyngeal therapeutics such as dexpanthenol solution(e.g., Bepanthen®, Dexpanthenol Solution 5% (NRF 7.3.) or chlorhexidine solution (e.g., Chlorhexidine Gluconate Lsg., Rp: Chlorhexidine Mouthwash Solution 0.1 or 0.2% (NRF 7.2.).

Favorable, healing in 10-14 days.

1. Chawareewong S et al (1978) Neonatal herpangina caused by Coxsackie A-5 virus. J Pediatr 93:492-494.
2. Cole RM (1951) Studies of Coxsackie viruses: observations on epidemiological aspects of group A viruses. Am J Pub Health 41: 1342