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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