Herpangina is a viral illness characterized by ulcers and lesions inside the mouth, sore throat, and fever. If similar shallow blister-like lesions appear on the palms or soles, it may be called hand, foot, and mouth disease.

Causes, incidence, and risk factors

Herpangina is caused by coxsackie virus, typically coxsackie group A viruses. Herpangina is characterized by mouth ulcers, but a high fever, sore throat, and headache may precede the appearance of the lesions. The lesions are generally ulcers with a white to whitish-gray base and a red border - usually on the roof of the mouth and in the throat. The ulcers may be very painful. Generally, there are only a few lesions.

The incidence of herpangina is unknown, but it is a common childhood infection. A history of herpangina at school or in the neighborhood increases the chances your child will develop the illness.


  • Lesions in mouth, as described above  
  • Similar lesions on feet, hands, buttocks  
  • Fever  
  • Loss of appetite  
  • Sore throat, or painful swallowing

Signs and tests

Tests are not normally necessary. Diagnosis can usually be made from the history and physical examination.


The symptoms are treated as necessary:

  • Acetaminophen or ibuprofen by mouth for fever and discomfort as recommended.  
  • Topical anesthetic agents for the mouth (these may contain benzocaine or xylocaine, and are usually not required).  
  • Non-irritating diet.  
  • Increased fluid intake.

Expectations (prognosis)

The illness normally clears up within a week.


There are usually no complications.

Calling your health care provider

Call your health care provider if the fever, sore throat, or throat lesions persist beyond 5 days, if your child is having trouble drinking liquids or looks dehydrated, or if the fever becomes excessive or persistent.


As with most viruses, there is no practical prevention. Awareness of other cases of herpangina in the neighborhood or school may allow earlier diagnosis.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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