What are the symptoms of herpangina?

Generally, herpangina is an acute infectious disease affecting the mucous membranes of the pharynx. Common symptoms include pharyngeal vesicles, severe sore throat, difficulty swallowing, excessive drooling, fever, and general malaise. A detailed analysis is as follows:

1. Pharyngeal Vesicles: The appearance of vesicles in the pharynx is a characteristic feature of this disease. Initially, small gray-white papules develop, evolving into vesicles within 1–2 days, surrounded by red halos. These vesicles are commonly found on the soft palate, uvula, tonsils, and posterior pharyngeal wall, varying in number. After 1–3 days, the vesicles rupture to form shallow ulcers covered with a yellowish pseudomembrane.

2. Severe Sore Throat: The vesicles and ulcers irritate the nerves in the pharynx, causing intense pain described as needle-like or burning, which significantly worsens during swallowing. Adults can usually clearly describe the location of throat pain, whereas infants and young children may cry persistently, refuse food, and even wake up at night due to pain.

3. Difficulty Swallowing: Due to severe throat pain, patients voluntarily reduce swallowing movements. Obstruction is more noticeable when eating solid foods, so patients often prefer liquid or semi-liquid diets. In severe cases, even swallowing saliva causes pain, and some patients may experience accumulation of oral secretions.

4. Excessive Drooling: This symptom is particularly prominent in infants and young children. Pain in the pharynx leads to weakened swallowing reflexes, making it difficult to swallow saliva normally, resulting in uncontrolled drooling. Although adults can better control their secretions, they still feel increased oral discharge and frequently need to spit to relieve discomfort.

5. Fever and Malaise: Fever commonly occurs at the onset of illness, typically ranging from 38.5°C to 39.5°C (moderate fever), although some patients may develop high fever. Fever usually lasts 2–4 days. During this period, patients may experience fatigue, irritability, or restlessness. However, systemic symptoms are generally milder compared to local pharyngeal manifestations.

Herpangina is contagious; therefore, isolation is necessary once symptoms appear to prevent cross-infection. Daily care should include maintaining good oral hygiene by rinsing the mouth with lukewarm water or normal saline. Diet should be light and soft to minimize irritation to the throat.