Herpangina, also called mouth blister

Blister

A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...

s, is the name of a painful mouth infection

Infection

An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 caused by coxsackievirus

Coxsackievirus

Coxsackievirus is a virus that belongs to a family of non enveloped linear positive-sense ssRNA viruses, Picornaviridae and the genus Enterovirus, which also includes poliovirus and echovirus. Enteroviruses are among the most common and important human pathogens and ordinarily its members are...

es. 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 echovirus

Echovirus

An ECHO virus, is a type of RNA virus that belongs to the genus Enterovirus of the Picornaviridae family...

es. 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.

Presentation

Though herpangina can be asymptomatic, symptoms usually associated are high fever

Fever

Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 and sore throat

Sore throat

A sore throat or throat pain is a common physical symptom usually caused by acute pharyngitis, or throat inflammation, though it also occurs in a number of other situations, such as post trauma and in diphtheria. It can cause mild to extreme pain....

.

A small number of lesions (usually 2 - 6) form in the back area of the mouth

Mouth

The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....

, particularly the soft palate

Soft palate

The soft palate is the soft tissue constituting the back of the roof of the mouth. The soft palate is distinguished from the hard palate at the front of the mouth in that it does not contain bone....

 or tonsillar pillars

Tonsil

Palatine tonsils, occasionally called the faucial tonsils, are the tonsils that can be seen on the left and right sides at the back of the throat....

. The lesions progress initially from red macules to vesicles and lastly to ulcerations which can be 2 - 4 mm in size. The lesions heal in 7 – 10 days.

Histologically

Histology

Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...

, the epithelial

Epithelium

Epithelium is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues line the cavities and surfaces of structures throughout the body, and also form many glands. Functions of epithelial cells include secretion, selective...

 cells

Cell (biology)

The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....

 show signs of intracellular and extracellular edema

Edema

Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...

.

Etymology

The term is derived from herp, an itching, and angina, a sore throat, literally "a choking."

Clinical features

• Most commonly affects infants and young children
• Typically occurs during the summer
• Typically spreads via the fecal-oral route
  Fecal-oral route
  The fecal-oral route, or alternatively, the oral-fecal route or orofecal route is a route of transmission of diseases, in which they are passed when pathogens in fecal particles from one host are introduced into the oral cavity of another potential host.There are usually intermediate steps,...
  
   or via the respiratory droplets.
• Fatigue will last about three to four days after treatment.

Symptoms

• Mild and short in duration (no more than 1 week)
• Sore throat and difficulty swallowing
• High fever
• Referred ear pain, especially when swallowing
• Small vesicular or punctuate lesions with white base on posterior soft palate near uvula and anterior fauces of the tonsils.

A diagnosis

Medical diagnosis

Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...

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

Treatment

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

Aspirin

Aspirin

Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...

 is to be avoided. However, ibuprofen

Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....

 and acetaminophen can be used to relieve fever and discomfort.

Drinking cold beverages, especially milk and eating ice cream are recommended. Hot and high acidity beverages are to be avoided.

External links

• Herpangina