Herpangina: Difference between revisions
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*[[Enteroviral Infections]] | *[[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] | |||
==Sources== | ==Sources== | ||
Revision as of 17:35, 3 July 2014
Background
- Caused by coxsackievirus
- Similar to Hand, Foot, and Mouth Disease but without skin 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 w/o skin lesions
- Lasts 7-10d
Differential Diagnosis
Workup
- None (clinical diagnosis)
- 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
- Home/Outpatient
See Also
External Links
SGEM - Oral Lidocaine in children for mouth ulcers
Sources
- ↑ 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