mild viral infection caused by several enteroviruses, most of which are in the subgroup Coxsackie A, seen most commonly in young children. The most distinctive symptom is a rash on the mucous membranes inside the mouth. The lesions in the mouth are round macules (nonraised spots) about 2 mm (0.1 inch) in diameter, occurring predominantly on the soft palate and tonsils. Herpangina usually starts abruptly with fever and sore throat, followed in some cases by loss of appetite, abdominal pain, vomiting, and other nonspecific symptoms; it is often confused with strep throat ( pharyngitis), but, unlike strep throat, it does not respond to treatment with penicillin or other antibiotics. The viruses that cause herpangina are worldwide in distribution and occur largely in the summer months; in the tropics, herpangina may be more evenly distributed throughout the year. The viruses that cause herpangina are transmitted from person to person, especially under conditions of crowding and imperfect hygiene. The infection is self-limited, resolving within one week and requiring no treatment.