Management of Herpangina
DOI:
https://doi.org/10.30649/denta.v14i2.4Keywords:
Herpangina, management, methisoprinol.Abstract
Background: Herpangina is an acute infectious disease with self-limiting properties. While herpangina may heal without any treatment, it may be followed by various complications such as meningitis, encephalitis, cardiomyopathy, or even death. In 2018, there was a 10.07% prevalence rate of viral infection in Banjarmasin city, South Kalimantan. One of which was herpangina. Objective: To elucidate the management of herpangina. Case: Young female patient, 11 years old, complained of multiple ulcerations on the posterior side of her mouth with excruciating pain when swallowing. Ulceration had appeared for three days which was initially commenced by fever and cough. Case Management: The patient was prescribed methisoprinol syrup 250 mg four times a day, ibuprofen syrup 250 mg four times a day, mouthwash containing aloe vera extract to be applied thrice daily, and explicit instruction for bed rest. Conclusion: Dental practitioners must differentiate herpangina from other differential diagnoses thus enabling the acquirement of final diagnosis through clinical examination. This will significantly assist dental practitioners to provide precise clinical therapy for the patient with herpangina.
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References
Yang T.O, Huang W.T, Chen M.H, Chen P.C. Diagnostic uncertainty of herpangina and hand foot and mouth disease and its impact on national enterovirus syndromic monitoring. Epidemiol Infect, 2016 ; 144 : 1512-1519.
Puenpa J, Mauleekoonphairoj J, Linsuwanon P, Suwannakarn K, Chieochansin T, Korkong S, Theamboonlers A, Poovorawan Y. Prevalence and Characterization of Enterovirus Infections among Pediatric Patients with Hand foot Mouth Disease, Herpangina and Influenza Like Illness in Thailand, 2012. Plos One, June 2014 ; 9(6) : 1-12
Apriasari M.L. The different symptoms determining management of hand foot and mouth disease and primary varicella zoster infection. Dental Journal (Majalah Kedokteran Gigi). March 2019 ; 52 (1) : 32-35
Regional Emerging Disease Intervention. A Guide to Clinical Management and Public Health Response for Hand, foot and Mouth Disease (HFMD), World Health Organization, Wetern Pacific Region, 2011. p: 18-22
Hatta I, Firdaus IWAK, Apriasari ML. The prevalence of oral mucosa disease of Gusti Hasan
Aman Dental Hospital in Banjarmasin, South Kalimantan. Dentino Journal Kedokteran Gigi. 2018; 2(2): 211–4.
Puenpa J, Mauleekoonphairoj J, Linsuwanon P, Suwannakarn K, Chieochansin T, Korkong S, Theamboonlers A, Poovorawan Y. Prevalence and Characterization of Enterovirus Infections among Pediatric Patients with Hand Foot Mouth Disease, Herpangina, and Influenza-Like Illness in Thailand 2012. Plos One, June 2014 ; 9 (6) : 1-8
Li W, Gao H.H, Zhang Q, Liu Y.J, Tao R, Cheng Y.P, Shu Q, Shang S.Q. Large Outbreak of Herpangina in Children Caused by Enterovirus in Summer of 2015 in Hangzhou, China. Scientific Report, October 2016; 6 : 35388: 1-5
Yao X, Bian L.L, Lu W.W, Li J.X, Mao Q.Y, Wng Y.P, Gao F, Wu X, Ye Q, Li X.L, Zhu F.C, Liang Z. Epidemiological and etiological characteristics of herpangina and hand foot mouth diseases in Jiangsu, China, 2013 – 2014. 2017 ; 13 (4) : 823-830
Apriasari M.L. Ulserasi Mukosa Mulut, Pustaka Panasea, Yogyakarta, 2019. p : 16-19
Glick M. Burket’s oral medicine. 12th ed. USA: People’s Medical Publishing House; 2014. p. 194–201.
Apriasari M.L. The management of herpes labialis, oral thrush and angular cheilitis in cases of oral diabetes. Dental Journal (Majalah Kedokteran Gigi). June 2019 ; 52 (2) : 76-80
Apriasari ML. Methisoprinol as an immunomodulator for treating infectious mononucleosis. Dental Journal (Majalah Kedokteran Gigi). 2016; 49: 1–4.
Bushra R, Aslam N. Review ariticle: An overview of clinic pharmacology of ibuprofen. Oman Medical Journal, July 2010; 25 (3): 155-161
Apriasari M.L, Pramitha S.R. Management of Varicella zoster in adult patient. Dentino Journal Kedokteran Gigi. March 2019 ; 4 (1) : 101-105
Setianingtyas D, Nafiah, Isidora K.S, Astrid P, Ramadhan H.P. Penatalaksanaan Hand Foot and Mouth Diseases Ynag Menyerang Ibu dan Anak. Jurnal PDGI Makassar , 2013 : 1-8
Puspitasari D, Apriasari M.L. Analysis of traumatic ulcer healing time under the treatment of the Mauli banana (Musa acuminata) 25% stem extract gel. Padjadjaran Journal of Dentistry. March 2017 ; 29 (1) : 21-25
Apriasari M.L, Endariantari A, Oktaviyanti I.K. The effect of 25% Mauli banana stem extract gel to increase the epithel thickness of wound healing process in oral mucosa. Dental Journal (Majalah Kedokteran Gigi). September 2015 ; 48 (3) : 151-154
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