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Child has fever, blisters on lip. Sores on gums, tiredness. What virus is this?

Hi, I ll give you a run down of my daughters illness that start two weeks ago.. She is now on the mend, but my youngest started developing the same symptoms this on Sunday (two days ago). My oldest started off with a 103 degree fever two weeks ago on a Saturday. She ran a fever all weekend and didn t have much of an appetite. On Monday, I took her to the doctor because she was still running a fever and had developed small blisters on her lip, chin , and corner of her mouth, in my small town and the doctor said her throat was extremely red, ran a strep which was negative but the put her on azithromycin while they cultured the swab. Tuesday her ls were extremely swollen and the two blisters now cover 2/3 her lip and spot on her chin looked worse and she cried because her mouth was sooo painful and complained of pain in her lower left temporal mandibular area, then called my mom (an RN) and they made her an apt with her primary pediatrician at the clinic my worked at 2 hrs away. This doc ran a CBC, her monocytes were flagged as a smidge high but everything else pointed to a viral infection. By this time the she now has sores all over her gums, tongue, back of throat, fever, swollen lymph glands in neck and jaw. Her doc prescribed magic mouthwash and said she had aphthous stomatitis , fancy word for canker sores caused by a viral infection and may take three weeks to clear up and to stay on the zpack doc 1 had prescribed. By Thursday her sores were a mess and I sent the doc2 a pic on my iPhone, because of the severity of what the sores on her lip and chin looked like now he prescribed clyndamycin to treat/prevent the possibility of a staff or merca infection (her strep culture had come back negative). After another 48hrs her sores looked better, but the one sore on her chin had developed three little nodules next too it that became one huge one on sat (we had now been sick for 8 days). Finally on Monday she is back at school, but now my youngest is starting similar symptoms with a high fever, tiredness, and sores. What virus is this herpagina similar to hand foot and mouth? My oldest has had a cold sore before, so I do not think is was oral herpes. The blister on her chin looked similar to and started like a chickenpox would.
Asked On : Sat, 24 Nov 2012
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Pediatrician 's  Response

Thank you for your query and the detailed description of the illness.

Without having a look at the lesions it is not possible for me to give you the likely cause of the problems that your daughters are experiencing. However, the conditions that you mentioned have the following features:
1. Herpangia: presents with fever and sore throat. The lesions are in the back area of the mouth
2. Hand, foot and mouth disease: lesions should have been present on the peripheries of the limbs too
3. Herpes Simplex: the lesion is usually painful and fever is not a feature of it

As your elder daughter had a history of cold sore the problem could be an infected Herpes Simplex infection which started resolving after you gave her antibiotic. However it is difficult to say that your younger daughter is having the same infection as I mentioned earlier that Herpes Simplex is usually not associated with fever.

The best course would be to do a detailed investigations including viral studies.

I hope I have answered your query to your satisfaction.

Wishing your daughters an early recovery.


Answered: Sat, 8 Dec 2012
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