AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentEasy
A 4-year-old child presents with a 2-day history of fever (101°F), poor oral intake, and multiple small, painful vesicles on the posterior oropharynx, tonsillar pillars, and soft palate. The child's hands and feet are clear. The mother reports no other family members are ill. Which of the following is the most likely diagnosis?
- AStreptococcal pharyngitis
- BHerpangina
- CPrimary herpetic gingivostomatitis
- DHand-Foot-Mouth Disease (HFMD)
Show answer & explanationAnswer & explanation
Correct answer: B. Herpangina
Herpangina is characterized by fever and small, painful vesicles and ulcers typically localized to the posterior oropharynx, tonsillar pillars, and soft palate. The absence of lesions on the hands and feet distinguishes it from Hand-Foot-Mouth Disease.
Why the other options are wrong
- A. Streptococcal pharyngitis usually presents with exudative tonsillitis, not vesicles on the posterior oropharynx.
- C. Primary herpetic gingivostomatitis would involve the anterior oral cavity (gums, tongue, buccal mucosa) and often presents with more severe gingival inflammation.
- D. HFMD would typically present with lesions on the hands and feet, which are absent here.
Herpangina Clinical Presentation
Herpangina is a viral illness caused by coxsackieviruses, primarily affecting young children. It is characterized by high fever, sore throat, and small, painful vesicles and ulcers on the posterior oral pharynx.
- Lesions are typically confined to the posterior oropharynx (tonsillar pillars, soft palate, uvula).
- Often accompanied by high fever, headache, and dysphagia.
- Self-limiting illness, usually resolving within 7-10 days.
Memory trick: Herpangina: Hurts Posteriorly, Hands & Feet are Clear!