Herpangina Pediatric Care Plan

By David Shafran, MD
Medically reviewed
January 8, 2021

What is Herpangina?

Herpangina is caused by the coxsackie virus. Unlike hand-foot-mouth disease which causes a characteristic bumpy rash in the mouth as well as the hands and feet, herpangina causes painful bumps only in the mouth. These lesions can make it difficult for your child to eat and drink.

Onset is usually abrupt and is often accompanied by a high fever. In rare cases, fever seizures can occur with the onset of fever

Complications of herpangina are exceedingly rare but when they occur tend to affect the brain.

Herpangina Diagnosis and Treatment

Herpangina is diagnosed based on history and physical exam. No blood work is required. 

There is no specific treatment for herpangina. Management is supportive and includes: 

  • Encouraging hydration
  • Pain control with Tylenol and ibuprofen 
  • Magic mouthwash (Maalox, Benedryl, viscous lidocaine) is not routinely recommended because it has not been proven to be effective and ingestion of lidocaine can be toxic. Ask if this is appropriate to try this in your child.

Check in with K If…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a Doctor in Person If…

  • Your child has a fever for greater than 7 days
  • Your child cannot drink because of mouth pain
  • Your child seems lethargic or unusually tired
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.