What is herpangina?

Herpangina is a viral infection of the mouth, most often caused by the Coxsackie virus. It affects children more commonly than adults. The distinguishing symptom of herpangina is small, blister-like ulcers or lesions on the roof of the mouth and at the back of the throat, which are often painful. It is generally considered to be a non-serious condition that ordinarily clears up in under 10 days.[1] The virus, however, is highly contagious and can easily be passed from person to person.[2]

Symptoms of herpangina

The early symptoms of herpangina are similar to other viral infections that affect the nose and throat. These include:[3]

  • Sore throat
  • Pain when swallowing
  • Headache
  • Sudden fever
  • Neck pain
  • Swollen lymph glands
  • Loss of appetite
  • Drooling and/or vomiting in children

Herpangina is different from other similar conditions because of the small blisters, and later ulcers, which form on the back of the throat. These ulcers are normally light grey and ringed in red, and in most cases will begin to appear within two days after the initial infection.

The symptoms of herpangina will normally disappear within 7 to 10 days. In cases where the high fever or ulcers do not disappear after five continuous days, medical advice should be sought as soon as possible.

Herpangina is generally considered to be a benign conditions, but complications are possible. One of the biggest risks of herpangina is dehydration, caused by an individual refusing food or water due to discomfort or lack of appetite.[4] Symptoms of dehydration can include fatigue, decreased urination and a dry mouth. If there is a suspicion of dehydration, seek a medical opinion right away.

Causes of herpangina

Herpangina is in most cases caused by group A coxsackieviruses, but can also be caused by group B coxsackieviruses, echovirus and enterovirus 71. Each of these viruses is highly contagious and most common in children younger than 7 years of age.[5] Children are susceptible to the virus because they do not yet possess the antibodies that defend against it. However, it is possible for herpangina to affect a person of any age.

Typically, the virus is spread when fecal matter from an infected individual comes into contact with the mouth area. This fecal matter can be carried on the hands, as well as on objects or surfaces. The virus can also be spread via the spray from a cough or sneeze of a person with herpangina.


The diagnosis is made by a doctor assessing symptoms and examining the mouth, throat and skin. Special diagnostic tests are not necessary.


Treatment of this condition aims to treat the symptoms. People with herpangina should stay at home and take plenty of fluids. Simple pain relief, such as paracetamol, is helpful for headaches, and drinking warm fluids or sucking lozenges can help with a sore throat. There is no specific medication to treat the Coxsackie A virus.


Good hygiene practices, including regular hand washing and staying home when sick, are the best ways to prevent this infection.

Other names for herpangina

  • Enteroviral vesicular pharyngitis

  1. Healthline. “Herpangina.” January 4, 2016. Accessed July 11, 2017.

  2. MedicineNet. “Herpangina.” July 21, 2015. Accessed July 11, 2017.

  3. Doctors Health Press. “Herpangina: Symptoms, Causes, Diagnosis, and Treatments.” June 15, 2017. Accessed July 11, 2017.

  4. aboutkidshealth. “Herpangina and Hand-Foot-and-Mouth Disease.” October 16, 2009. Accessed July 11, 2017.

  5. Medline Plus. “Herpangina.” October 7, 2015. Accessed July 11, 2017.