Blisters in Throat – Symptoms and How to Treat it

Blisters in the throat are usually a childhood illness caused by a virus. The most common condition causing blisters is herpangina, characterized by small and blister-like ulcers appearing on the roof of the mouth and in the back of the throat. The infection can sometimes cause sore throat, neck pain, headache, and sudden fever.

With that in mind, let’s talk more about herpangina [1]https://en.wikipedia.org/wiki/Herpangina. The condition is similar to hand-foot-mouth disease, which is another viral infection which affects children.

Both conditions are caused by enteroviruses, or a group of viruses mostly affecting the gastrointestinal tract [2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490919/.

Your body reacts by producing antibodies to fight off the infection. Antibodies can recognize and destroy harmful substances, including viruses and bacteria.

However, the problem with children and infants is they do not have developed antibodies yet, or have a low amount of them.

Therefore, they are more susceptible to viruses. The good news is that blisters in the throat caused by herpangina are treatable and clear up within one week to 10 days.

Symptoms of herpangina

The symptoms can vary from one person to another [3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067559/.

However, the common symptoms include:

  • Sore throat
  • Headache
  • Neck pain
  • Sudden fever
  • Swollen lymph glands
  • Loss of appetite
  • Difficulty swallowing
  • Vomiting
  • Drooling

The blisters or ulcers in the back of the mouth and throat appear two days after the initial infection. They can be light gray in color, and sometimes have a red border.

The ulcers heal on themselves within 7 days, but you can speed up the process.

The question is should you consult with a physician, or wait for the condition to pass on its own?

Well, there are symptoms that are alarming, and demand a visit to the doctor’s office [4]https://www.nejm.org/doi/full/10.1056/NEJM195108232450801:

  • Fever over 106F that does not go away
  • Mouth sores that last for more than five days
  • Dehydration symptoms, including lack of tears and dry mouth
  • Decreased urine output
  • Dark urine
  • Fatigue

What causes herpangina?

In most cases, the condition is caused by Group A coxsackieviruses. But that doesn’t mean that group B coxsackieviruses cannot cause it as well. Other viruses include enterovirus and echovirus.

All of these viruses are highly contagious and can spread from one person to another. This is even more challenging in schools and childcare centers. Children and people who are infected are most contagious during the first week.

The virus is typically transmitted through contact with fecal matter. It can also be spread through contact with droplets from an infected person’s sneeze or a cough.

If you touch your mouth after touching something that is contaminated with fecal particles or droplets from an infected person, you might get the infection.

Even bigger problem is that the virus can live on surfaces and objects, including countertops and toys for a couple of days. That makes it even easier for spreading.

Risk factors

While the virus can affect anyone, children under the age of five are usually most commonly affected. Children who attend school, camps, and childcare facilities are at even higher risk.

During the summer and fall, the risk is higher in the United States [5]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287953/.

Is the condition contagious?

As mentioned previously, the virus infection is extremely contagious. It can easily pass from one child to another through contaminated surfaces, unwashed hands, and sneezing and coughing.

That is why it is recommended that an infected child stays at home. Typically, the people infected with the virus are most contagious during the first week.

How long is the incubation period?

The normal course of any virus infection includes an incubation period. This is the period between exposure to the virus and the development of the symptoms. In the case of herpangina, the incubation period can last between one to two weeks.

How long does herpangina last?

The entire duration of the illness is four to seven days. But that is after the incubation period has finished [6]https://www.ncbi.nlm.nih.gov/books/NBK507792/.

The good news is that the prognosis is excellent. In very few cases, patients may refuse to drink or eat and will require hospitalization for intravenous fluids.

The most important aspect in terms of treatment is to manage the pain of a young child. In some rare cases, enteroviral infections can cause aseptic meningitis, but these patients make a full recovery.

Is there a difference between herpangina and hand, foot, and mouth disease?

The cause for both viral infections is enteroviruses. Both cause symptoms like oral ulcers and blisters [7]https://en.wikipedia.org/wiki/Hand,_foot,_and_mouth_disease. The difference is the location of the blisters.

For example, in hand, foot, and mouth disease, the lesions occur at the front of the mouth. In herpangina, on the other hand, blisters occur at the back of them outh. Another difference is that in most cases (75% to be exact), patients with hand, foot, and mouth disease develop skin lesions on the palms and soles. That symptom is very rare in herpangina children patients.

Is there a difference between herpangina and Herpes Simplex-1

Another common infection among children is herpes simplex-1, or HSV-1 virus [8]http://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus. And unlike herpangina, the HSV-1 virus does not have a seasonal preference.

The difference, again, is in the location of the lesions. In the case of HSV-1 virus, the blisters appear in the inner cheek tissue, gums, tongue, hard and soft palate. In more than half of cases with HSV-1 virus, patients develop lesions on the lips and adjacent skin, also known as cold sores.

The HSV-1 virus infection also lasts longer. The common duration is between seven and 10 days, while herpangina lasts between four and seven days. Some common symptoms include moderate fever, headache, malaise, and reduced appetite.

Diagnosis and treatment

The ulcers and blisters caused by herpangina are unique. Because of that, a simple physical exam is more than enough for your doctor to diagnose the condition. In most cases, there is no need for special diagnostic tests.

The primary goal of treatment is to reduce and manage the symptoms, most notably pain in your mouth caused by ulcers. The treatment plan depends on factors like age, symptoms, and tolerance for medications. Because it is a viral infection, antibiotics are not effective.

Some options include:

  • Ibuprofen and other anti-inflammatory medications
  • Topical anesthetics that can provide relief for a sore throat
  • Increased fluid intake, especially cold milk and water

Can you prevent herpangina?

The best way to prevent herpangina is to practice good hygiene habits. Always wash your hands thoroughly, especially before meals and after using the restroom. Cover your mouth and nose when sneezing or coughing to prevent spread of germs.

Wash your hands frequently when you care for a child with herpangina, especially after coming in contact with soiled diapers or mucus. Clean any surfaces, including toys, with a disinfectant to prevent germ infection.

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