II. Epidemiology

  1. Occurs in summer months (may be epidemic)
  2. Preschool children and their siblings

III. Pathophysiology

  1. Fecal-oral transmission

IV. Etiology

  1. Coxsackie Virus
  2. Echovirus

VI. Signs

  1. Non-toxic appearance
  2. Multiple small 1-2 mm Vesicle or ulcers
    1. Soft Palate, posterior pharynx, Tonsillar Pillars and uvula
    2. Spares the anterior pharynx
    3. Contrast Hand Foot and Mouth Disease which spares the posterior pharynx
  3. No skin lesions
    1. Unlike Hand Foot and Mouth Disease

VII. Differential Diagnosis

  1. Hand Foot and Mouth Disease
    1. Vesicles in anterior pharynx, sparing posterior pharynx
  2. Aphthous Ulcer
  3. Primary Herpetic Gingivostomatitis
    1. External Vesicles are only seen with HSV (not with Herpangina or Hand Foot and Mouth Disease)

VIII. Course

  1. Illness of 1 week duration with rare complication

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