Herpangina typically occurs during the summer, and various enteroviruses cause the condition. The enteroviral agents causing herpangina belong to the Picornaviridae family of viruses. These viruses typically spread via the fecal-oral route, although the viruses may spread via the respiratory route or through fomites. The incubation period typically is 7-14 days. Viremia occurs after inoculation and, subsequently, results in distant sites of infection.
Clinical symptoms occur after viral replication at secondary sites of infection.
Bilateral, anterior, cervical lymphadenopathy may occur, resulting from infection of the posterior oropharynx. After resolving clinical symptoms, enteroviral infection may continue asymptomatically in the gastrointestinal tract. Herpangina typically is a mild and self-limited illness. Associated complications occur rarely. Clinical manifestations may vary, depending on the strain of virus causing the infection.