Herpangina

Herpangina is a viral infection of the back of the mouth.

The main symptoms include:

• sore throat and pain with swallowing 
• fever for 2 to 3 days 
• small ulcers (2 to 3 mm) surrounded by a red ring on the roof of the mouth and near the tonsils. There are no ulcers in the front of the mouth or on the gums. The average child has 5 of these ulcers, though there can be more.

Throat pain relief 
Children over age 1 can sip warm chicken broth or apple juice. Children over age 4 can suck on hard candy (butterscotch seems to be a soothing flavor) or lollipops. Children over age 6 can gargle with warm water containing a little table salt or antacid solution.

Diet 
Offer a soft, bland diet to reduce the pain. Cold drinks and milkshakes are especially good. Do not give your child salty foods, citrus fruits, or foods that need much chewing. Encourage your child to drink favorite fluids to prevent dehydration. For very young children, give fluids by cup rather than from a bottle because the nipple can increase the pain.

Fever and pain relief 
Give your child acetaminophen (Tylenol) or ibuprofen (Advil) for the sore throat or for a fever over 102°F (39°C).

Common mistakes to avoid 
Avoid expensive throat sprays or throat lozenges. Not only are they no more effective than hard candy, but many also contain an ingredient (benzocaine) that may cause an allergic reaction.

Antibiotics will not help a viral infection.

Herpangina is caused by several Coxsackie A viruses. A person can have herpangina up to 5 times.

The sore throat and ulcers usually last 5 to 7 days.

If you feel that your child needs immediate medical care.

• The pain becomes severe. 
• Your child can't drink enough fluids. 
• The ulcers last longer than 10 days. 
• Your child develops a fever that lasts for 3 days. 
• You feel your child is getting worse.

Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.