Herpetic sore throat in children and adults - symptoms and treatment

The condition of the oral mucosa is one of the indicators of human health. It is involved in most pathological processes occurring in the body and reacts even to minor changes in the microbial composition of the oral cavity. Therefore, many people have experienced red dots on their gums and palate at least once in their lives. This is a natural reaction to mechanical and temperature stimuli. Redness may be caused by:

• consumption of hot and spicy foods and drinks;
• damage to soft tissues with a hard brush, toothpick, bones and pieces of hard food;
• Using the wrong toothpaste or mouthwash;
• wearing prostheses, braces, retention caps.

However, red spots can also indicate various diseases. Let's look at the most common cases.

Causes of herpangina

Herpangina can be caused by about 70 serotypes of enteroviruses. Most often these are Coxsackie B, Coxsackie A17 viruses and enterovirus 711.

Since the only carrier of enteroviruses is humans, you can become infected through contact with a sick person or with a virus carrier who has no symptoms of the disease1. According to the literature, the number of virus carriers can be up to 46% of people2.

The virus is released into the external environment with feces and droplets of saliva. It is also contained in bubbles that appear in the patient’s throat. Enterovirus infections most often affect children, although the disease also occurs in adults5.

The patient or virus carrier excretes viruses from the upper respiratory tract within 3 weeks after infection, and with feces - up to 8 weeks. In the first two weeks, herpetic sore throat is most contagious1.

You can become infected in the following ways:

• through dirty hands, objects and food if they are exposed to the virus;
• drinking contaminated water from a reservoir;
• upon contact with a patient or virus carrier.

The herpangina virus is also transmitted transplacentally - from mother to fetus3.

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The appearance of a pimple on the tongue: diseases and treatment

The most harmless reason for the appearance of a pimple on the tip of the tongue is mechanical damage. Regular antiseptic treatment is enough to get rid of the problem. To relieve inflammation, you can use decoctions of sage and chamomile. A prerequisite is not to touch the wound with your hands, as you risk causing a more serious infection.

Allergy

It usually manifests itself as a scattering of small pimples throughout the tongue plate; if treatment is not addressed immediately, the pathology penetrates the root of the tongue, the frenulum and affects the larynx.

Symptoms of herpetic sore throat

The disease begins acutely. From the moment of infection to the first symptoms, it takes from 2 to 14 days3. The temperature rises to 38-39°C. The patient feels weakness, headache, chills, less often nausea, possible vomiting and enlargement of the submandibular lymph nodes, 1,2,3.

Herpangina goes through several stages2:

• The day before the rash appears in the throat, the patient feels a mild pain. On examination, you may notice redness of the palatine arches and the back wall of the pharynx.
• Then, rashes appear on the mucous membrane of the soft palate, palatine arches, tonsils and uvula - small papules (nodules) up to 5 mm in diameter with a red rim.
• The nodules turn into vesicles, which open after 1-2 days.
• In their place, painful erosions with a gray-white coating form.

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Types of inflammatory diseases of the oral cavity

These diseases are classified depending on what causes the inflammation, as well as on the location of its source in the mouth.

Thus, general lesions of the mucous membrane are called stomatitis [1]. If the mucous membrane of only the tongue, lip, palate, gums or alveolar process becomes inflamed, they speak of glossitis , cheilitis, palatinitis, gingivitis or periostitis, respectively.

Depending on the reasons that caused the inflammatory process, these diseases are divided into:

• infectious;
• traumatic;
• symptomatic;
• specific.

If left untreated, inflammation can occur with complications and have negative consequences both for the teeth, gums, mouth and pharynx, and for the general health of a person.

Herpetic sore throat in children

Children usually become infected at school or kindergartens2,3. Due to pain and fever, they are restless, tearful, and often refuse to eat and drink because food irritates erosions on the mucous membrane and causes discomfort. But due to refusal to drink water or juices, children often develop dehydration. At the same time, the child’s tongue becomes dry, and the elasticity of the skin decreases1. Convulsions may occur due to high temperature1.

Blistering rashes in children can appear not only on the mucous membrane of the throat, but also on the hands and feet, and even on the buttocks and forearms. This manifestation of enterovirus infection is called viral pemphigus of the oral cavity and extremities or mouth-hand-foot syndrome. The disease is contagious in 100% of cases, is often mild, and can affect nails3.

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Causes of stomatitis in a child

In childhood stomatitis, the mucous membrane of the oral cavity is affected: small pimples of white or yellowish color, filled with liquid, appear on its surface. In some cases, ulcers form.

Stomatitis is predominantly a childhood disease, although it can also occur in adults. The rash affects the inner surface of the cheeks, tongue and gums. The disease causes a lot of inconvenience: pimples hurt and itch, their appearance is accompanied by a burning sensation in the mouth.

Among the main reasons for the development of stomatitis are:

• poor oral hygiene;
• injury to the mucous membrane;
• diseases of the gastrointestinal tract;
• oral burn;
• pathogenic bacteria that enter the oral cavity from dirty hands, toys, etc.

Course of herpetic sore throat

The diagnosis of herpetic sore throat can be made by an otolaryngologist, therapist or pediatrician after examining the patient and clarifying his complaints. To monitor changes characteristic of a viral infection, the doctor may prescribe a general blood test, and to confirm enteroviral sore throat, a specialist may prescribe a pharyngeal smear and a blood test for specific antibodies. The pathogen can also be detected in stool or inflammatory fluid that is released from vesicles1,4.

Manifestations of herpetic sore throat can go away on their own in less than 10 days. But in any case, at the first symptoms of the disease, you should definitely consult a doctor. You cannot self-medicate2,3.

In some cases, herpetic sore throat can cause complications from the nervous system. In this case, 1 appears:

• severe spasm of the neck muscles, due to which the child cannot bend his head;
• weakness of the muscles of the limbs;
• disturbance of consciousness.

A severe complication of herpetic sore throat is damage to the soft membranes of the brain, brain and spinal cord1,3.

Newborns are at highest risk of developing complications, so they need careful treatment and care3. It is important to maintain hydration and give your child enough fluids1.

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Other reasons for finding red dots in the sky

Red dots on the upper palate may be the result of the following rare diseases:

Pyogenic granuloma

Occurs in a place often subject to trauma. It is necessary to excise the tumors at the root, after which electrocoagulation therapy is prescribed.

Kaposi's sarcoma

It is a malignant neoplasm with a purple hue. Local chemotherapy is prescribed, and measures are taken to increase the patient’s immunity.

Pathechia in the sky

These are small flat spots that often appear during mononucleosis. May be a manifestation of smallpox, thrombocytopenia, typhoid fever and endocarditis.

If a red rash occurs in the mouth, you do not need to make a diagnosis and prescribe treatment yourself.
It is necessary to consult with a specialist, find out the cause of the spots and receive appropriate treatment. The DentalGuru dental clinic employs experienced and professional dentists who guarantee painless and effective treatment of stomatitis and other dental diseases. This article is for informational purposes only, please consult your doctor for details!

Treatment of herpetic sore throat

Patients with complications require hospitalization in an infectious diseases hospital and treatment under the supervision of specialized specialists - a neurologist and a cardiologist. If the doctor has recommended treatment at home, it is necessary to closely monitor the patient's condition2.

The sick person should be isolated and stay in a clean, well-ventilated area so as not to infect other family members. Quarantine must be observed until symptoms subside1.

For herpangina you should 1,3,4:

• Wash your hands as often as possible, including after feeding and changing a sick child’s diaper.
• Disinfect surfaces and objects with which the patient has been in contact.
• Drink enough fluids to avoid dehydration. At the same time, pay attention to the temperature of the drink: hot, warm drinks irritate the mucous membranes and cause additional discomfort. You can drink cool drinks.
• Consume food in liquid or mushy form. Spicy, salty, sour foods, including fresh fruits even in the form of puree, are not suitable for a patient with herpetic sore throat.
• Rinse your mouth with a saline solution after every meal to maintain oral hygiene and prevent bacterial infections from erosions.
• Use a soft toothbrush to reduce trauma to the mucous membrane.

Currently, there is no proven antiviral drug to treat herpangina by acting on its causative agent. Sometimes a doctor may prescribe medications that support local immunity of the pharyngeal mucosa1. Antibiotics are not prescribed for herpangina6.

The goal of treatment for herpangina is to relieve the symptoms of the disease4.

If the body temperature is above 38.5°C, physical methods such as cold compresses and ice packs may be used. Your doctor may also recommend anti-inflammatory and antipyretic medications1. Local treatment includes agents with anti-inflammatory, analgesic, enveloping and antiseptic effects1.

For the symptomatic treatment of herpetic sore throat, the doctor may prescribe the drugs HEXORAL®7,8,9,10,11. It is convenient to use HEXORAL® spray to irrigate the pharyngeal mucosa. The active substance of the spray is hexethidine. It acts against the main bacteria found in the oral cavity and pharyngeal mucosa8. The drug is also active against some viruses and fungi of the genus Candida8. Thanks to the local anesthetic effect of hexethidine, HEXORAL ® spray helps reduce pain8. HEXORAL®7 solution is suitable for rinsing. The use of HEXORAL ® spray and solution is allowed in children over 3 years of age7,8.

If herpangina causes severe pain and discomfort, adolescents over 12 years of age and adults can benefit from HEXORAL ® TABS EXTRA lozenges, which contain the anesthetic lidocaine10. For children over 4 years of age, HEXORAL ® TABS lozenges may be suitable. The anesthetic benzocaine in their composition helps reduce pain in the throat and mouth9.

All medications for herpetic sore throat should be used only after consultation with a doctor. In case of severe erosions, HEXORAL ® solution and spray are contraindicated7,8, and lozenges can only be prescribed by a specialist after examining the pharynx9,10.

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The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist.

How to treat childhood stomatitis

Once the diagnosis has been made, treatment for stomatitis should begin as soon as possible. It is necessary to keep in mind that prescribing medications yourself: the decision can only be made by a pediatrician who has information about how this or that medicine can further affect the well-being of a small patient. First of all, the doctor must prescribe a scraping to determine the type of causative agent of the disease, and a virological study: depending on this, the type of treatment is prescribed.

The duration of treatment is influenced by the advanced stage of the disease and the type of stomatitis: on average, it is possible to overcome the disease within a week, provided that the doctor’s recommendations are fully followed.

Children's stomatitis: treatment with medications

Doctors prescribe symptomatic medications, the purpose of which is to get rid of the symptoms that accompany the development of the disease.

Appointed:

• vitamin complexes to strengthen the child’s immunity as a whole;
• antiviral drugs;
• antipyretic drugs;
• gels and ointments for treating the oral cavity.

In addition, it is recommended to drink plenty of fluids and eat a diet that excludes the consumption of spicy, sour and highly salty foods.

The most commonly prescribed drugs for stomatitis are:

• Miramistin. An antifungal solution that prevents wound infection. The drug starts the process of regeneration of damaged tissues.
• Vinilin is an anesthetic with a healing effect. The medicine forms a protective film on the surface of the ulcers, protecting them from irritation when eating food, as a result of which the healing process is accelerated.
• Nystatin is an effective treatment for candidal stomatitis.
• Metrogyl Denta is an antibacterial drug applied twice a day to damaged areas of the mucous membrane.
• Acyclovir is an antiviral drug that prevents new lesions of the rash from appearing. The drug is applied up to 6 times during the day. Thanks to its use, the formation of crusts is accelerated.

Children's stomatitis: treatment with folk remedies

Many parents, in addition to or even instead of medications, prefer to use traditional medicine. As mentioned above, you should not do this without the consent of your doctor, however, you cannot fail to mention these methods of treatment.

So, among these funds it is worth highlighting:

• soda-salt solution. An equal amount of soda and salt are dissolved in a glass of water (about half a teaspoon of each component). It is recommended to rinse your mouth with the resulting solution 4 times a day after meals;
• infusion of chamomile with honey. For the solution, take a glass of boiling water and a tablespoon of chamomile. When the liquid cools, add 2 teaspoons of honey. The product is used for rinsing 3 times a day;
• brilliant green is the most affordable remedy available for sale in any pharmacy. It dries out wounds and prevents new foci of disease from forming.

Sources

1. Corsino CB, Ali R, Linklater DR. Herpangina. 2022 Jun 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29939569. https://www.ncbi.nlm.nih.gov/books/NBK507792/
2. Ter-Baghdasaryan L.V., Ratnikova L.I., Stenko E.A. Clinical and epidemiological aspects of enterovirus infection // Infectious diseases: news, opinions, training. 2022. T. 9, No. 1. P. 88-93. doi: 10.33029/2305-3496-2020-9-1-88-93 https://infect-dis-journal.ru/ru/jarticles_infection/672.html?SSr=2601343bdb01ffffffff27c__07e4040b011a36-9772
3. Alacheva Z. A., Rybalka O. B., Kulichenko T. V. Should everyone escape from Coxsackie?! Or fear has big eyes. Issues of modern pediatrics. 2017; 16 (4): 286–290. doi: 10.15690/vsp.v16i4.1774) https://vsp.spr-journal.ru/jour/article/viewFile/1787/713
4. Herpangina Brenda L. Tesini. University of Rochester School of Medicine and Dentistry // MSD Handbook - 2019 https://www.msdmanuals.com/ru/professional/infectious-diseases/enteroviruses/herpangina
5. Kozlovskaya O.V., Katanakhova L.L., Kamka N.N., Evseeva A.N. Epidemiological, clinical and diagnostic features of enterovirus infection in children and adults. Bulletin of Surgu State University. Medicine. 2018;(2):56-60. https://surgumed.elpub.ru/jour/article/view/140/141
6. Kuo KC, Yeh YC, Huang YH, Chen IL, Lee CH. Understanding physician antibiotic prescribing behavior for children with enterovirus infection. PLoS One. 2022 Sep 7;13(9):e0202316. doi: 10.1371/journal.pone.0202316. PMID: 30192893; PMCID: PMC6128467. https://pubmed.ncbi.nlm.nih.gov/30192893/
7. Instructions for use of the drug HEXORAL® SOLUTION:
8. Instructions for use of the drug HEXORAL® AEROSOL:
9. Instructions for use of the drug HEXORAL® TABS:
10. Instructions for use of the drug HEXORAL® TABS EXTRA:

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