Herpangina — MFDS Part 1 MCQ

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ModerateMicrobiologyHerpanginaMFDS Part 1

A 5-year-old child presents with an abrupt fever, sore throat and multiple small vesicles and ulcers on the posterior soft palate and tonsillar pillars. There is no associated skin rash. Which virus is the most likely cause?

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Correct answer: D — Coxsackievirus A

The correct answer is **A, Coxsackievirus A**. Abrupt fever with small vesicles and ulcers concentrated on the posterior soft palate and tonsillar pillars is characteristic of herpangina, which is most commonly caused by Coxsackie A enteroviruses. Other enteroviruses can occasionally produce the syndrome, but none is offered here. Primary HSV-1 usually causes widespread painful oral ulceration with prominent gingivitis. Epstein–Barr virus causes infectious mononucleosis, typically with tonsillitis, lymphadenopathy and palatal petechiae rather than posterior vesicles. Varicella-zoster virus causes varicella or a unilateral dermatomal eruption, while measles is associated with Koplik spots and a generalised maculopapular rash.

Reference: Hebbar VB, Linklater DR. Herpangina. StatPearls, updated 2026. https://pubmed.ncbi.nlm.nih.gov/29939569/