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Herpangina Classification and external resources ICD-10 B08.5 ICD-9 074.0 DiseasesDB 30777 MedlinePlus 000969 eMedicine med/1004 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] Contents 1 Presentation 2 Etymology 3 Clinical features 4 Symptoms 5 Treatment 6 See also 7 References 8 External links Presentation Though herpangina can be asymptomatic, symptoms usually associated are high fever and sore throat. 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. The lesions heal in 7 – 10 days. Histologically, the epithelial cells show signs of intracellular and extracellular edema. 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 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 can be made from clinical signs and symptoms, and treatment consists of minimizing the discomfort of symptoms. Treatment Treatment is usually supportive only,[5] as the disease is self-limiting and usually runs its course in less than a week. Aspirin is to be avoided.[6] However, ibuprofen and acetaminophen can be used to relieve fever and discomfort.[7] Drinking cold beverages, especially milk and eating ice cream are recommended. Hot and high acidity beverages are to be avoided.[8] See also List of cutaneous conditions References ^ herpangina virus at Dorland's Medical Dictionary ^ herpangina at Dorland's Medical Dictionary ^ Michael I. Greenberg (2005). Greenberg's text-atlas of emergency medicine. Lippincott Williams & Wilkins. pp. 156. ISBN 9780781745864. http://books.google.com/books?id=tjZttRRH8H8C&pg=PA156. Retrieved 11 April 2010.  ^ Ralph D. Feigin (2004). Textbook of pediatric infectious diseases. Elsevier Health Sciences. pp. 170. ISBN 9780721693293. http://books.google.com/books?id=G6k0tpPMRsIC&pg=PA170. Retrieved 11 April 2010.  ^ "ULCERATIVE LESIONS OF THE ORAL CAVITY". http://www.utmb.edu/otoref/grnds/Ulcer-oral-021016/Ulcer-oral-021016.htm.  ^ http://jama.ama-assn.org/cgi/content/abstract/247/22/3089 ^ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001964/ ^ http://mx.globedia.com/que-es-la-herpangina- External links Herpangina v · d · eInfectious skin disease: Viral cutaneous conditions, including viral exanthema (B00–B09, 050–059) DNA virus Herpesviridae Alpha HSV (Herpes simplex, Herpetic whitlow, Herpes gladiatorum, Herpetic keratoconjunctivitis, Herpetic sycosis, Neonatal herpes simplex, Herpes genitalis, Herpes labialis, Eczema herpeticum, Herpetiform esophagitis) · Herpes B virus (B virus infection) VZV (Chickenpox, Herpes zoster, Herpes zoster oticus, Ophthalmic zoster, Disseminated herpes zoster, Zoster-associated pain, Inflammatory skin lesions following zoster infection, Modified varicella-like syndrome) Beta Human herpesvirus 6/Roseolovirus (Exanthema subitum, Roseola vaccinia) Cytomegalic inclusion disease Gamma KSHV (Kaposi's sarcoma) Poxviridae Ortho Variola (Smallpox, Eczema vaccinatum, Alastrim) · MoxV (Monkeypox) · CV (Cowpox) · VV (Vaccinia, Generalized vaccinia, Progressive vaccinia) Buffalopox Para Farmyard pox: Milker's nodule · Bovine papular stomatitis · Pseudocowpox · Orf Sealpox Other Yatapoxvirus: Tanapox · Yaba monkey tumor virus MCV (Molluscum contagiosum) Papillomaviridae HPV (Wart/Plantar wart, Heck's disease, Genital wart (giant), Laryngeal papillomatosis, Butcher's wart, Bowenoid papulosis, Epidermodysplasia verruciformis, Verruca plana, Pigmented wart, Verrucae palmares et plantares ) BPV (Equine sarcoid) Parvoviridae Parvovirus B19 (Erythema infectiosum, Reticulocytopenia, Papular purpuric gloves and socks syndrome) RNA virus Paramyxoviridae MeV (Measles) Togaviridae Rubella virus (Rubella, Congenital rubella syndrome) · Alphavirus infection · Chikungunya fever Picornaviridae CAV (Hand, foot and mouth disease, Herpangina) · FMDV (Foot-and-mouth disease) · Boston exanthem disease Ungrouped unknown/multiple: Asymmetric periflexural exanthem of childhood · Post-vaccination follicular eruption · Lipschütz ulcer · Eruptive pseudoangiomatosis · Viral-associated trichodysplasia · Gianotti–Crosti syndrome M: VIR virs(prot)/clss cutn/syst (hppv/hiva, infl/zost/zoon)/epon drugJ(dnaa, rnaa, rtva, vacc) M: INT, SF, LCT anat/phys/devp noco(i/b/d/q/u/r/p/m/k/v/f)/cong/tumr(n/e/d), sysi/epon proc, drug (D2/3/4/5/8/11) v · d · eOral pathology: Stomatognathic disease (K06, K11–K14, 523, 527–529) Vestibule of mouth Lip Cheilitis (Angular, Actinic) · Herpes labialis · Plasma cell cheilitis · Cheilitis granulomatosa · Chapped lips Cheilitis exfoliativa · Cheilitis glandularis · Allergic contact cheilitis Drug-induced ulcer of the lip · Epidermization of the lip Cheek Morsicatio buccarum Oral cavity proper Hard, soft, and periapical tissues gingival disease: Gingivitis (Desquamative gingivitis), Pericoronitis, Necrotizing ulcerative gingivitis, Noma, Epulis · Acute necrotizing ulcerative gingivitis Periodontitis  · Ulcer Salivary glands Sialadenitis (Parotitis) · Benign lymphoepithelial lesion · Necrotizing sialometaplasia · Ranula · Sialolithiasis · Mucocele of salivary gland saliva: Drooling/sialorrhea · Xerostomia Tongue Glossitis (Geographic tongue) · Fissured tongue · Glossodynia · Black hairy tongue · Strawberry tongue · Caviar tongue · Median rhomboid glossitis · Osseous choristoma of the tongue · Smooth tongue General Stomatitis: Aphthous ulcer (Major aphthous ulcer) · Herpetic stomatitis Velopharyngeal inadequacy oral mucosa: Erythroplakia · Leukoplakia (Hairy leukoplakia) · White sponge nevus To be grouped from derm Acquired dyskeratotic leukoplakia · Angina bullosa haemorrhagica · Behçet syndrome · Cutaneous sinus of dental origin · Cyclic neutropenia · Epulis fissuratum · Eruptive lingual papillitis · Melanocytic oral lesion · Melkersson–Rosenthal syndrome · Mucosal lichen planus · Oral Crohn's disease · Oral florid papillomatosis · Oral melanosis · Plasmoacanthoma · Proliferative verrucous leukoplakia · Pyogenic granuloma · Pyostomatitis vegetans · Recurrent intraoral herpes simplex infection · Stomatitis nicotina · Trumpeter's wart · Vestibular papillomatosis To be grouped from periodontology Diagnoses Chronic periodontitis · Localized aggressive periodontitis · Generalized aggressive periodontitis · Periodontitis as a manifestation of systemic disease · Necrotizing periodontal diseases · Abscesses of the periodontium · Combined periodontic-endodontic lesions Pathogenesis A. actinomycetemcomitans · Capnocytophaga sp. · F. nucleatum · P. gingivalis · P. intermedia · T. forsythia · T. denticola Pathologic entities Calculus · Edentulism · Fremitus · Furcation defect · Gingival enlargement · Gingival pocket · Gingivitis · Horizontal bony defect · Linear gingival erythema · Occlusal trauma · Periodontal pocket · Periodontal disease · Periodontitis · Plaque · Recession · Vertical bony defect M: MOU anat/devp noco/cofa(c)/cogi/tumr, sysi proc (peri), drug (A1) This infection-related cutaneous condition article is a stub. You can help Wikipedia by expanding it.v · d · e This medical sign article is a stub. You can help Wikipedia by expanding it.v · d · e