Herpangina: Difference between revisions
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==Background== | ==Background== | ||
*Caused by | *Caused by [[coxsackie]]virus | ||
*Similar to [[Hand, Foot, and Mouth Disease]] but without hand and foot lesions | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:Herpangina2016.jpg|thumb|Oral herpangitic lesions.]] | |||
*Prodrome | *Prodrome | ||
**Sudden onset of high fever, sore throat, malaise | **Sudden onset of high [[fever]], [[sore throat]], malaise | ||
*Rash appears 24-48hr after prodrome | *[[Rash]] appears 24-48hr after prodrome | ||
**Vesicles 1-2 mm in size that rupture leaving shallow, painful whitish ulcers on soft palate/posterior pharynx | **Vesicles 1-2 mm in size that rupture leaving shallow, painful whitish ulcers on soft palate/posterior pharynx | ||
**Similar to hand, foot, mouth disease but | **Similar to hand, foot, mouth disease but with out hand and foot lesions | ||
*Lasts 7-10d | *Lasts 7-10d | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Peds Rash DDX}} | |||
== | ==Evaluation== | ||
*Clinical diagnosis, based on history and physical examination | |||
**If unsure, see [[Pediatric Fever]] | |||
==Management== | ==Management== | ||
{{Hand Foot Mouth Management}} | |||
==Disposition== | ==Disposition== | ||
*Discharge | |||
==See Also== | ==See Also== | ||
*[[Enteroviral Infections]] | |||
*[[Pediatric Rashes]] | *[[Pediatric Rashes]] | ||
== | ==External Links== | ||
SGEM - [http://thesgem.com/2014/06/sgem81-sore-mouth-lidocaine-for-oral-ulcers/ Oral Lidocaine in children for mouth ulcers] | |||
==References== | |||
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category: | [[Category:Dermatology]] | ||
[[Category: | [[Category:Pediatrics]] | ||
Latest revision as of 20:51, 10 September 2020
Background
- Caused by coxsackievirus
- Similar to Hand, Foot, and Mouth Disease but without hand and foot lesions
Clinical Features
- Prodrome
- Sudden onset of high fever, sore throat, malaise
- Rash appears 24-48hr after prodrome
- Vesicles 1-2 mm in size that rupture leaving shallow, painful whitish ulcers on soft palate/posterior pharynx
- Similar to hand, foot, mouth disease but with out hand and foot lesions
- Lasts 7-10d
Differential Diagnosis
Pediatric Rash
- Atopic dermatitis
- Bed bugs
- Contact dermatitis
- Drug rash
- Erythema infectiosum (Fifth disease)
- Hand-foot-and-mouth disease
- Henoch-schonlein purpura (HSP)
- Herpangina
- Herpes simplex virus (HSV)
- Infectious mononucleosis
- Meningitis
- Measles
- Molluscum contagiosum
- Roseola infantum
- Rubella (German measles)
- Scabies
- Scarlet fever
- Smallpox
- Varicella (Chickenpox)
Evaluation
- Clinical diagnosis, based on history and physical examination
- If unsure, see Pediatric Fever
Management
- No specific therapy for most; self-limited
- NSAIDS and cool liquids for pain
- Encourage good hand hygiene to prevent spread
- Some recommend Magic Mouthwash/oral lidocaine if not tolerating PO intake, although evidence suggests no better than placebo[1]
- In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning[2][3]
Disposition
- Discharge
See Also
External Links
SGEM - Oral Lidocaine in children for mouth ulcers
References
- ↑ Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9
- ↑ FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm
- ↑ Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39