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Herpangina is a topic covered in the 5-Minute Clinical Consult.

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  • Highly infectious viral disease caused most commonly by coxsackievirus and other enterovirus species (1)
  • Characteristics:
    • Fever of short duration (<5 days)
    • Characterized by painful vesicular or ulcerated lesions in the posterior pharynx, soft palate, tonsils, and uvula
    • Incubation period of ~4 days
  • Usual course: acute and self-limited
  • System(s) affected: endocrine/metabolic; gastrointestinal


  • Year-round in tropical climates
  • Peak summer and fall incidence in temperate climates
  • Predominant age: typically <5 years (can occur at any age group)
  • Predominant sex: male = female

Etiology and Pathophysiology

  • Common
    • Coxsackievirus A, types 1 to 10, 16, and 22
  • Infrequent
    • Coxsackievirus B, types 1 to 5
    • Echovirus, types 6, 9, 11, 17, 22, and 25
    • Other enteroviruses (e.g., Enterovirus B) (2)

Risk Factors

  • Contact with infected person
  • Exposure to diaper changes or toilet training may increase risk (parents/teachers/daycare employees).

General Prevention

  • Avoid contact with infected individuals.
  • Fecal–oral and respiratory droplet transmission—general hygiene (hand washing) is important.
  • Hand washing by preschool-aged children and their caregivers protects against spread (3).

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Stephens, Mark B., et al., editors. "Herpangina." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816123/all/Herpangina.
Herpangina. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816123/all/Herpangina. Accessed April 18, 2019.
Herpangina. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816123/all/Herpangina
Herpangina [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816123/all/Herpangina.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Herpangina ID - 816123 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816123/all/Herpangina PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -