Herpangina is caused by coxsackievirus group A, types 1-6, 8, 10, and 22 most commonly. Most commonly occurring in the summer and autumn, herpangina presents with a sudden onset of high fever, sore throat, headache, and malaise followed by eruption of oral vesicles 1 to 2 mm in size within 24 to 48 h. The vesicles quickly rupture, leaving numerous shallow, painful ulcers. The soft palate, uvula, posterior pharynx, and tonsilar pillars are usually affected, sparing the buccal mucosa, tongue, and gingiva. The disease lasts 7 to 10 days and can be distinguished from herpetic gingivostomatitis by the lack of gingival involvement. 11

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