The baby suddenly has a fever with sore throat, refusal to eat, bad breath, and an examination reveals some small red blisters in the mouth and throat. Parents may be puzzled: What is the difference between this and a normal cold? What is herpes pharyngitis? Herpes pharyngitis is a common and frequent disease in children, mostly in the summer and autumn. The pathogen is mostly coxsackievirus group A. The onset of the disease is rapid, manifested by sudden high fever, sore throat, salivation, anorexia, vomiting and so on. On physical examination, the pharynx is found to be congested, and several or even dozens of grayish-white herpes of 2-4 mm in size are seen on the mucosa of the pharyngeal-palatal arch, uvula, and soft palate, surrounded by a red halo, which breaks down to form small ulcers after 1 to 2 days. The disease can be transmitted mainly through respiratory, intestinal (fecal-oral) or insect-borne routes, such as through contaminated hands, food, clothing, utensils, etc. It can develop in children aged 2 to 10 years, but mostly in infants and young children, and can be epidemic or small epidemic, with a duration of about 1 week, without complications or sequelae. Difference with HFMD Children with HFMD also have herpes, so what is the difference between the two herpes? The biggest difference between the two is that in children with herpes pharyngitis, the rash appears only in the mouth, whereas in most children with HFMD, the rash first appears in the throat and then progresses to the hands and feet, accompanied by fever. The rash that emerges is usually the size of a small grain of rice or a green bean, surrounded by small reddish grayish-white herpes or red papules that are not painful, itchy, or crusty. Another important difference is that although pharyngitis may be combined with bacterial infection, complications such as encephalitis do not occur, which means that serious and life-threatening illnesses are almost never seen. In contrast, a small number of children with HFMD can have complications such as myocarditis, pulmonary edema, and viral encephalitis, and individual children with severe disease can die due to the rapid progression of the disease. Differentiation from the common cold Since the initial symptoms of herpes pharyngitis are not very different from those of the common cold, it can easily be mistaken for a cold and delay treatment. How can you tell the difference? The common cold is mostly caused by respiratory viruses, and the illness is characterized by a runny nose, blocked nose, cough, fatigue, loss of appetite, fever, and a body temperature of about 38°C. Herpes pharyngitis is a special type of “cold” (i.e. upper respiratory tract infection), caused by enterovirus coxsackie A group, and is somewhat contagious. The symptoms are usually a sudden high fever with severe sore throat, difficulty swallowing, increased salivation, loss of appetite, and weakness. There are grayish-white papules or herpes in the oral cavity surrounded by a red halo. In addition to anti-infection and rehydration treatment, the following points should be noted for the care of the child at home. A reasonable diet is needed. Eat a light and easily digestible liquid or semi-liquid diet, avoid overly hot, cold, acidic and spicy food to avoid stimulating the oral mucosa, and add more vitamin-rich vegetables and fruits. Second, more ventilation, more water. For children with high fever, keeping the surrounding environment ventilated and quiet will help them dissipate heat and lower their metabolic rate, and drinking more water will help them sweat and dissipate heat. First, physical cooling (such as wet compresses on the head, warm baths or warm water baths neck, underarm, groin ice packs and alcohol baths, etc.), if the effect is not good, can be used under the guidance of the doctor ibuprofen suspension and other antipyretic drugs. If the child swallows uncomfortably and refuses to eat, he can be given supplementary fluids to maintain water-electrolyte balance. Third, care for the oral cavity. Because herpes or ulcers occur in the oral mucosa and tongue of the child, it will cause painful swallowing and affect the diet, so it is especially important to keep the mouth clean and do a good job of oral comfort care. Rinse the child’s mouth with light salt water several times a day. In addition, ice borax can be applied to the child’s throat to reduce sore throat, and oral vitamin B can also be taken to promote ulcer healing. The child’s used dishes must be disinfected with boiling water to prevent oral infection. Fourth, observe the child’s condition. Parents should carefully observe the emotional changes of the child to detect any discomfort in time and seek early medical attention.