Name
HERPANGINA
DESCRIPTION
DETAIL
CAUSES: . COMMON: . Coxsackievirus A - types 1-10, 16 and 22 . INFREQUENT: . Coxsackievirus B - types 1-5 . Echovirus - types 6, 9, 11, 17, 22, 25 . Other enterovirus -------------------------------------------------------------------------- DIFFERENTIAL DIAGNOSIS . Herpes simplex - multiple ulcers on lips and anterior mouth. Diagnose with Herpes culture. . Drug reactions - cutaneous lesions often present (urticaria, erythema multiforme) . Recurrent aphthous stomatitis . Buccal, labial, alveolar, mucosal ulcers . Recurrent crops . Few systemic symptoms . Lichen planus - painful ulcer, white Lacy pattern on mucosa or may have cutaneous lesions which are purple and pruritic . Hand, foot and mouth disease - classic distribution of vesicular rash on hands, buttocks, feet and mouthβ’ Slight leukocytosis (< 50%) β’ Positive viral culture - mouth washings, stool SPECIAL TESTS β’ Complement fixation β’ Hemagglutinin inhibition tests β’ Serum antibodies to Coxsackievirus - titers should show a fourfold rise in serial samples
TYPENOTES
RISK FACTORS Contact with infected personGENERAL MEASURES: β’ Self-limited β’ Palliative and supportive β’ Hydration DRUG(S) OF CHOICE : β’ Analgesics - acetaminophen, NSAIDs β’ Topical anesthetics β’ Mouthwash - aqueous solution of 1% dyclonine and 1% diphenhydramine (Benadryl) in 50% attapulgite (Kaopectate) β’ 2% viscous lidocaine solution PATIENT MONITORING: Hydration PREVENTION/AVOIDANCE: Avoid contact with infected individual POSSIBLE COMPLICATIONS: . Complications are rare . Exanthem . Aseptic meningitis . Myocarditis . Encephalitis EXPECTED COURSE/PROGNOSIS: Complete recovery
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
COMPLETE BLOOD COUNT, THROAT SWAB FOR C / S TEST