Differentiating Herpangina from Herpes in a Toddler
My 14-month-old daughter, who weighs 25 pounds, has no history of recurrent medications and no identified allergies, is currently using Tylenol for pain relief. Two nights ago, she developed a fever that reached 102.9 degrees. I managed to reduce the fever with Tylenol. She experienced a slight fever yesterday but returned to her normal self today. Concerned about her condition, I took her to the doctor after noticing sores in her throat and an increase in drooling. I was particularly anxious about strep throat, given that her sister frequently suffers from it. During the visit, the doctor identified two blisters on her gums, located on the side of her mouth near emerging teeth. He indicated that the presence of sores at the front of her mouth suggested it was herpes. Inquiring about the potential use of antiviral medication, I was informed that the only recommendations were supportive measures like pain management and ensuring she stays hydrated. No diagnostic tests were conducted. Naturally, this diagnosis has left me feeling concerned, despite knowing that it is quite prevalent. It’s possible she contracted the virus at daycare or from someone who didn’t exhibit symptoms. After returning home, I did some research and discovered that herpangina could also be a possibility; the symptoms seem to align, considering the sudden onset, the time of year, and potential daycare exposure. Furthermore, I noted that herpangina can involve the gums as well, but she only has a few lesions on her gums and mostly in the back of her throat, with no sores present on her lips or outside of her mouth. Should I consider scheduling a follow-up with our pediatrician for blood tests? Is it reasonable for me to be skeptical about the initial diagnosis? If I had complete certainty it was herpes, I would have insisted on antivirals. (Please let me know if my concerns seem unwarranted.) Additionally, I realized that I forgot to mention that I am still breastfeeding. Is it safe for me to continue nursing her if she has herpes?
Answers (1)
6/27/2025, 9:30:55 PM
OpenHealth AI
It's entirely reasonable to have concerns about your daughter's health and diagnosis. Based on your description, it’s understandable to question whether she has herpes or herpangina. Both conditions can cause similar symptoms, including sores in the mouth and fever, especially in young children.
Understanding Herpangina and Herpes:
- Herpangina is caused by enteroviruses and typically presents with fever and painful sores, primarily at the back of the throat. It's common in toddlers and usually resolves on its own.
- Oral Herpes (Herpes Simplex) often presents with blisters around the mouth and lips but can also cause sores in the throat. It, too, is common in children and can be transmitted easily.
Your daughter's symptoms—fever, sores in the throat, and drooling—align with both conditions. Since she has no active sores on her lips or face, this could be indicative of herpangina, which often focuses on the back of the throat.
Next Steps:
- Monitor Symptoms: Continue to watch her symptoms, particularly the sores and fever, and ensure she stays hydrated. You can continue to use Tylenol as needed for pain and fever.
- Hydration and Nutrition: Offer her plenty of fluids and soft foods that are easy to swallow to minimize discomfort.
- Follow-up with the Pediatrician: Considering your concerns and the ambiguity of the diagnosis, it is reasonable to schedule a follow-up with your pediatrician. You can discuss:
- The possibility of herpangina.
- Your anxiety about the diagnosis and whether additional tests, such as viral cultures or blood tests, could help clarify the situation.
- The appropriate time frame to reassess her condition if things do not improve.
- Breastfeeding Safety: Yes, it is generally considered safe to continue breastfeeding if your daughter has herpes. You should practice good hygiene, such as washing your hands frequently and avoiding kissing her near her mouth, to minimize the risk of transmission.
When to Seek Immediate Care:
If she develops severe symptoms—such as persistent high fever, difficulty swallowing, unusual lethargy, or signs of dehydration (not urinating, dry mouth)—seek medical attention promptly.
Your concerns are valid, and seeking clarity from your pediatrician shows your commitment to your daughter's health. Remember, you know her best, and your intuition about her care is crucial. Let me know if you have any other questions or need further clarification!
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