What is herpetic pharyngitis?

What is herpetic pharyngitis?
Herpangina is an acute upper respiratory tract infectious disease caused by enterovirus infection, the main pathogens of which are coxsackievirus and enterovirus.
Clinical manifestations include fever, sore throat, herpes in the pharyngeal isthmus, etc.
It is contagious, with a higher incidence in summer and autumn, and the main transmission route is fecal-oral or respiratory.
The prognosis is generally good, and most children recover on their own in about a week.
How many stages does herpetic pharyngitis go through?

1. Incubation period: about 2-4 days. In most cases, there are no special symptoms, but it is contagious. It is not recommended to go to crowded places frequently and take good self-protection measures;
2. Prodromal stage: It starts with a sudden high fever, which peaks in 24-48 hours. The body temperature can rise to 39-41°C, accompanied by headache, throat discomfort, muscle pain, etc. Infants and young children often vomit, refuse to eat, and even have high fever convulsions. Older children and adults often have severe sore throat, dysphagia, myalgia in the limbs, anorexia and fatigue. Symptomatic treatment is required at this stage, and antipyretics can be given to those with fever;
3. Acute stage: At this time, small gray papules may appear in the pharynx, which develop into blisters and ulcers within 24 hours, surrounded by a 1-5mm red halo. Skin damage at this stage usually occurs on the anterior pillars of the tonsils, soft palate and uvula. Antiviral treatment is mainly given at this stage;
4. Recovery period: The ulcer begins to heal in 1-5 days, and the fever usually subsides and the symptoms disappear within 3 days.
What are the relevant examinations for herpetic pharyngitis?
Blood routine test and C-reactive protein
If the total white blood cell count increases and the C-reactive protein level significantly rises, bacterial infection should be considered.
Blood biochemistry
Generally, children have slightly elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), etc.; some seriously ill children may have elevated cardiac troponin (cTn) and blood sugar. This test can help to determine the condition of the child.
Etiology and serology
Testing of pharyngeal and stool specimens can confirm viral infection and the specific type of virus.
Chest x-ray
Children with lung involvement may show increased bilateral lung markings and interstitial parenchymal infiltration, while some children may have unilateral lung changes.
Magnetic resonance imaging
If the nervous system is affected, damage to the gray matter of the spinal cord and brain stem can be observed. This examination can help determine whether the child has neurological damage.
The treatment measures for herpetic pharyngitis are mainly to get more rest, drink more water, eat a light diet, pay attention to oral hygiene, ventilate the home frequently, wash hands frequently, etc. If there is bacterial infection, antibiotics can be used under the guidance of a doctor. At the same time, herpetic pharyngitis is highly contagious and should be treated in isolation.
Author: Wang Honglian