An example of herpangina in a child
Classification and external resources
Specialty infectious disease
ICD-10 B08.5
ICD-9-CM 074.0
DiseasesDB 30777
MedlinePlus 000969
eMedicine med/1004 article/218502
MeSH D006557

Herpangina, also called mouth blisters, is the name of a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term "herpangina virus" refers to coxsackievirus A)[1] but it can also be caused by coxsackievirus B or echoviruses.[2] Most cases of herpangina occur in the summer,[3] affecting mostly children. However, it occasionally occurs in adolescents and adults. It was first characterized in 1920.[4]

Signs and symptoms

Symptoms include sudden fever with sore throat, headache, loss of appetite, and often neck pain. Within two days of onset an average of four or five (but sometimes up to twenty) 1 to 2 mm diameter grayish lumps form and develop into vesicles with red surrounds, and over 24 hours these become shallow ulcers, rarely larger than 5 mm diameter, that heal in one to seven days. These lesions most often appear on the tonsillar pillars (adjacent to the tonsils), but also on the soft palate, tonsils, uvula, or tongue.[5]

A small number of lesions (usually 2 - 6) form in the back area of the mouth, particularly the soft palate or tonsillar pillars. The lesions progress initially from red macules to vesicles and lastly to ulcerations which can be 2 – 4 mm in size.


Typically spreads via the fecal-oral route or via the respiratory droplets.


Histologically, the epithelial cells show signs of intracellular and extracellular edema.


A diagnosis can be made from clinical signs and symptoms, and treatment consists of minimizing the discomfort of symptoms.[5]


Treatment is usually supportive only,[6] as the disease is self-limiting and usually runs its course in less than a week.

No Antiviral medications exist for Coxsackie A or other Enteroviruses.



The term is derived from the Greek herp, creeping, snake like, and Latin angina, quinsy, literally "inflammation or swelling of the throat or part of the throat, esp. tonsillitis".[7][8]


  1. "Herpangina Virus" at Dorland's Medical Dictionary
  2. "Herpangina" at Dorland's Medical Dictionary
  3. Michael I. Greenberg (2005). Greenberg's text-atlas of emergency medicine. Lippincott Williams & Wilkins. p. 156. ISBN 978-0-7817-4586-4. Retrieved 11 April 2010.
  4. Ralph D. Feigin (2004). Textbook of pediatric infectious diseases. Elsevier Health Sciences. p. 170. ISBN 978-0-7216-9329-3. Retrieved 11 April 2010.
  5. 1 2 "Herpangina". Merckmanuals.com. Merck. Retrieved 21 December 2014.
  6. "ULCERATIVE LESIONS OF THE ORAL CAVITY". Utmb.edu. Retrieved 21 December 2014.
  7. "Home : Oxford English Dictionary". Oed.com. Retrieved 21 December 2014.
  8. "Quinsy - Define Quinsy at Dictionary.com". Dictionary.com. Retrieved 21 December 2014.
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