Springdale Mason Pediatrics



  • A viral infection that causes little ulcers in the back of the mouth

Call or Return If

  • Trouble breathing or drooling occurs
  • Sore throat lasts more than 7 days
  • Fever lasts more than 3 days
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Small ulcers (sores) surrounded by a red ring. May first look like tiny water blisters before they change to open sores.
  • Located near the tonsils and on the roof of the mouth.(soft palate)
  • The average child has 5 of these ulcers, though there can be more.
  • There are no ulcers in the front of the mouth or on the gums.
  • Sore throat is the main symptom. Pain is made worse when the child swallows.
  • Also causes pain with swallowing and decreased appetite.
  • Fever for 2 to 3 days
  • No runny, cough or other symptoms of a cold


  • Herpangina is caused by Coxsackie A viruses.
  • A person can get herpangina up to 5 times.

Prevention of Spread to Others

  • Good hand washing can prevent spread of infection.

After Care Advice

  • Herpangina is a throat infection caused by a Coxsackie virus.
  • It will go away on its own.
  • Your job is to make sure your child drinks enough fluids.
  • Herpangina can be treated at home.
  • Here is some care advice that should help.
Sore Throat Pain Relief:
  • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
  • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
  • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
  • Medicated throat sprays or lozenges are generally not helpful.
Pain Medicine:
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Antibiotics Not Needed:
  • Antibiotics are not helpful for viral infections.
  • They can only kill bacteria.
Fluids and Soft Diet:
  • Try to get your child to drink adequate fluids.
  • Goal: Keep your child well hydrated.
  • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
  • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
  • Swollen tonsils can make some solid foods hard to swallow.
  • For babies, offer fluids in a cup, spoon or syringe rather than a bottle. Reason: The nipple may increase pain.
What to Expect:
  • Fever lasts 2 to 3 days.
  • The sore throat and ulcers last 4 or 5 days.
Return to School:
  • Your child can return to school after the fever is gone.
  • Your child should feel well enough to join in normal activities.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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