Herpes sore throat in children and adults

In this article we will look at why a child may develop pimples on the tongue. We will also find out how to treat this disease.

Japanese doctors claim that early signs of major diseases appear primarily in the tongue. The appearance of various pimples and pimples on a child’s tongue can be explained in different ways. In our article we will look at the reasons why a child may develop such symptoms on the tongue, what to do in such cases, and whether these problems can be avoided.

Causes of herpangina

Herpangina can be caused by about 70 serotypes of enteroviruses. Most often these are Coxsackie B, Coxsackie A17 viruses and enterovirus 711.

Since the only carrier of enteroviruses is humans, you can become infected through contact with a sick person or with a virus carrier who has no symptoms of the disease1. According to the literature, the number of virus carriers can be up to 46% of people2.

The virus is released into the external environment with feces and droplets of saliva. It is also contained in bubbles that appear in the patient’s throat. Enterovirus infections most often affect children, although the disease also occurs in adults5.

The patient or virus carrier excretes viruses from the upper respiratory tract within 3 weeks after infection, and with feces - up to 8 weeks. In the first two weeks, herpetic sore throat is most contagious1.

You can become infected in the following ways:

through dirty hands, objects and food if they are exposed to the virus;
drinking contaminated water from a reservoir;
upon contact with a patient or virus carrier.

The herpangina virus is also transmitted transplacentally - from mother to fetus3.

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The appearance of a pimple on the tongue: diseases and treatment

The most harmless reason for the appearance of a pimple on the tip of the tongue is mechanical damage. Regular antiseptic treatment is enough to get rid of the problem. To relieve inflammation, you can use decoctions of sage and chamomile. A prerequisite is not to touch the wound with your hands, as you risk causing a more serious infection.

Allergy

It usually manifests itself as a scattering of small pimples throughout the tongue plate; if treatment is not addressed immediately, the pathology penetrates the root of the tongue, the frenulum and affects the larynx.

Symptoms of herpetic sore throat

The disease begins acutely. From the moment of infection to the first symptoms, it takes from 2 to 14 days3. The temperature rises to 38-39°C. The patient feels weakness, headache, chills, less often nausea, possible vomiting and enlargement of the submandibular lymph nodes, 1,2,3.

Herpangina goes through several stages2:

The day before the rash appears in the throat, the patient feels a mild pain. On examination, you may notice redness of the palatine arches and the back wall of the pharynx.
Then, rashes appear on the mucous membrane of the soft palate, palatine arches, tonsils and uvula - small papules (nodules) up to 5 mm in diameter with a red rim.
The nodules turn into vesicles, which open after 1-2 days.
In their place, painful erosions with a gray-white coating form.

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Herpetic sore throat in children

Children usually become infected at school or kindergartens2,3. Due to pain and fever, they are restless, tearful, and often refuse to eat and drink because food irritates erosions on the mucous membrane and causes discomfort. But due to refusal to drink water or juices, children often develop dehydration. At the same time, the child’s tongue becomes dry, and the elasticity of the skin decreases1. Convulsions may occur due to high temperature1.

Blistering rashes in children can appear not only on the mucous membrane of the throat, but also on the hands and feet, and even on the buttocks and forearms. This manifestation of enterovirus infection is called viral pemphigus of the oral cavity and extremities or mouth-hand-foot syndrome. The disease is contagious in 100% of cases, is often mild, and can affect nails3.

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Causes of pimples

There are many reasons for the appearance of such formations on a child’s tongue. Let's try to understand each of them in more detail.

Tongue injuries

After three months of age, babies begin to actively explore the world around them, including trying to taste everything. But the objects that enter the child’s mouth are not always sterile. Older children often have a habit of chewing on sharp objects, which can also scratch or injure the tongue. Even minor trauma to the mucous membranes in combination with the ingress of microbes can provoke an inflammatory reaction and the appearance of painful pimples, which are often localized on the tip of the tongue.

Candidiasis or thrush

In children under one year of age, the immune system is not fully formed, so any disease leads to a decrease in the body’s protective properties. The consequence of this is candidiasis in the oral cavity - active growth of fungi of the genus Candida on the mucous membranes, which can also be provoked by taking antibiotics. One of the typical manifestations of thrush is the appearance of pimples and a cheesy white coating on the entire tongue surface, spreading to the entire oral cavity. If you remove such plaque, you can find redness, swelling and even the appearance of small ulcers underneath it.

Stomatitis

With stomatitis, a large number of small white pimples appear on the root of the tongue at its base, on its lateral surfaces or at the tip, which are very painful and cause discomfort while eating or talking. Such pimples can merge to form extensive ulcers. In severe cases, the child feels generally unwell and has a high body temperature.

Allergy

Children under two years of age are more likely than adults to have allergic reactions. One of the manifestations of allergies is the appearance of small whitish or red pimples on the tongue. They can be located both at the tip and in the area of the root of the tongue and move to other parts of the oral mucosa: lips, gums, palate. Most often, such formations bother the child, itch and cause pain when eating and swallowing. But this is not characterized by an increase in body temperature.

An increase in allergy symptoms and the appearance of new pimples is caused by eating a product to which you are hypersensitive. Often the cause of such allergic reactions is toothpaste or other oral care products, even if they are recommended for use in children.

Angina

A bacterial infection that affects the tonsils in children can also spread to the lymphoid tissue, which is located at the root of the tongue closer to the throat. This is accompanied by the appearance of white pimples with a purulent coating in the tongue area. When the pus is removed, areas of redness and slight swelling are exposed. The formations are painful, interfere with normal swallowing and significantly worsen the child’s well-being: he becomes capricious, refuses to eat, and his body temperature rises. Often, if there are such pimples near the throat, you can feel enlarged lymph nodes.

Herpetic infection

Infection with the herpes virus most often occurs in childhood, and when the body’s immune defense is reduced, the infection can worsen. In this case, watery small pimples on a red background appear on the tongue, which can also appear on the child’s lips and throat. They are very painful and after opening them, shallow ulcers appear, which prevent the child from eating and talking normally.

Dysbacteriosis and unbalanced nutrition

Errors in the nutrition of a child, especially of a younger age, as well as disturbances in the normal composition of the intestinal microflora can lead to glossitis - inflammation of the mucous membrane of the tongue. This leads to the fact that the epithelium of the papillae begins to actively divide, they take on the appearance of inflamed red or whitish pimples. They rarely bother the child; sensitivity to hot, cold or sour foods may only change.

Course of herpetic sore throat

The diagnosis of herpetic sore throat can be made by an otolaryngologist, therapist or pediatrician after examining the patient and clarifying his complaints. To monitor changes characteristic of a viral infection, the doctor may prescribe a general blood test, and to confirm enteroviral sore throat, a specialist may prescribe a pharyngeal smear and a blood test for specific antibodies. The pathogen can also be detected in stool or inflammatory fluid that is released from vesicles1,4.

Manifestations of herpetic sore throat can go away on their own in less than 10 days. But in any case, at the first symptoms of the disease, you should definitely consult a doctor. You cannot self-medicate2,3.

In some cases, herpetic sore throat can cause complications from the nervous system. In this case, 1 appears:

severe spasm of the neck muscles, due to which the child cannot bend his head;
weakness of the muscles of the limbs;
disturbance of consciousness.

A severe complication of herpetic sore throat is damage to the soft membranes of the brain, brain and spinal cord1,3.

Newborns are at highest risk of developing complications, so they need careful treatment and care3. It is important to maintain hydration and give your child enough fluids1.

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Treatment of herpetic sore throat

Patients with complications require hospitalization in an infectious diseases hospital and treatment under the supervision of specialized specialists - a neurologist and a cardiologist. If the doctor has recommended treatment at home, it is necessary to closely monitor the patient's condition2.

The sick person should be isolated and stay in a clean, well-ventilated area so as not to infect other family members. Quarantine must be observed until symptoms subside1.

For herpangina you should 1,3,4:

Wash your hands as often as possible, including after feeding and changing a sick child’s diaper.
Disinfect surfaces and objects with which the patient has been in contact.
Drink enough fluids to avoid dehydration. At the same time, pay attention to the temperature of the drink: hot, warm drinks irritate the mucous membranes and cause additional discomfort. You can drink cool drinks.
Consume food in liquid or mushy form. Spicy, salty, sour foods, including fresh fruits even in the form of puree, are not suitable for a patient with herpetic sore throat.
Rinse your mouth with a saline solution after every meal to maintain oral hygiene and prevent bacterial infections from erosions.
Use a soft toothbrush to reduce trauma to the mucous membrane.

Currently, there is no proven antiviral drug to treat herpangina by acting on its causative agent. Sometimes a doctor may prescribe medications that support local immunity of the pharyngeal mucosa1. Antibiotics are not prescribed for herpangina6.

The goal of treatment for herpangina is to relieve the symptoms of the disease4.

If the body temperature is above 38.5°C, physical methods such as cold compresses and ice packs may be used. Your doctor may also recommend anti-inflammatory and antipyretic medications1. Local treatment includes agents with anti-inflammatory, analgesic, enveloping and antiseptic effects1.

For the symptomatic treatment of herpetic sore throat, the doctor may prescribe the drugs HEXORAL®7,8,9,10,11. It is convenient to use HEXORAL® spray to irrigate the pharyngeal mucosa. The active substance of the spray is hexethidine. It acts against the main bacteria found in the oral cavity and pharyngeal mucosa8. The drug is also active against some viruses and fungi of the genus Candida8. Thanks to the local anesthetic effect of hexethidine, HEXORAL ® spray helps reduce pain8. HEXORAL®7 solution is suitable for rinsing. The use of HEXORAL ® spray and solution is allowed in children over 3 years of age7,8.

If herpangina causes severe pain and discomfort, adolescents over 12 years of age and adults can benefit from HEXORAL ® TABS EXTRA lozenges, which contain the anesthetic lidocaine10. For children over 4 years of age, HEXORAL ® TABS lozenges may be suitable. The anesthetic benzocaine in their composition helps reduce pain in the throat and mouth9.

All medications for herpetic sore throat should be used only after consultation with a doctor. In case of severe erosions, HEXORAL ® solution and spray are contraindicated7,8, and lozenges can only be prescribed by a specialist after examining the pharynx9,10.

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The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist.

Preventive measures to help avoid the appearance of pimples on a child’s tongue

To avoid the appearance of such not very pleasant manifestations in a child, you should teach him to follow the following rules:

Keep your mouth clean.
Do not chew foreign objects.
Visit your dentist regularly
Eat only foods that do not irritate the mucous membranes.
At the first sign of infection, consult a doctor.
Strengthen your immune system by consuming the maximum amount of seasonal vegetables and fruits.
Take the necessary vitamins according to your age

You need to monitor your child's tongue - this is an indicator of the condition of the internal organs.
Make it a habit to monitor the condition of your baby's tongue. Teach him from childhood to monitor his health and adhere to basic hygiene rules.

Sources

Corsino CB, Ali R, Linklater DR. Herpangina. 2021 Jun 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29939569. https://www.ncbi.nlm.nih.gov/books/NBK507792/
Ter-Baghdasaryan L.V., Ratnikova L.I., Stenko E.A. Clinical and epidemiological aspects of enterovirus infection // Infectious diseases: news, opinions, training. 2021. Vol. 9, No. 1. pp. 88-93. doi: 10.33029/2305-3496-2020-9-1-88-93 https://infect-dis-journal.ru/ru/jarticles_infection/672.html?SSr=2601343bdb01ffffffff27c__07e4040b011a36-9772
Alacheva Z. A., Rybalka O. B., Kulichenko T. V. Should everyone escape from Coxsackie?! Or fear has big eyes. Issues of modern pediatrics. 2017; 16 (4): 286–290. doi: 10.15690/vsp.v16i4.1774) https://vsp.spr-journal.ru/jour/article/viewFile/1787/713
Herpangina Brenda L. Tesini. University of Rochester School of Medicine and Dentistry // MSD Handbook - 2019 https://www.msdmanuals.com/ru/professional/infectious-diseases/enteroviruses/herpangina
Kozlovskaya O.V., Katanakhova L.L., Kamka N.N., Evseeva A.N. Epidemiological, clinical and diagnostic features of enterovirus infection in children and adults. Bulletin of Surgu State University. Medicine. 2018;(2):56-60. https://surgumed.elpub.ru/jour/article/view/140/141
Kuo KC, Yeh YC, Huang YH, Chen IL, Lee CH. Understanding physician antibiotic prescribing behavior for children with enterovirus infection. PLoS One. 2021 Sep 7;13(9):e0202316. doi: 10.1371/journal.pone.0202316. PMID: 30192893; PMCID: PMC6128467. https://pubmed.ncbi.nlm.nih.gov/30192893/
Instructions for use of the drug HEXORAL® SOLUTION:
Instructions for use of the drug HEXORAL® AEROSOL:
Instructions for use of the drug HEXORAL® TABS:
Instructions for use of the drug HEXORAL® TABS EXTRA:

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