From the Research
The recommended treatment for herpangina in an 8-month-old is primarily supportive care, focusing on maintaining adequate hydration and managing symptoms, as it is a self-limiting viral illness that typically resolves within 7-10 days. The treatment approach should include offering frequent small amounts of cool liquids or popsicles to soothe the throat and prevent dehydration. For pain and fever management, acetaminophen (Tylenol) can be given at a dose of 10-15 mg/kg every 4-6 hours as needed, not exceeding 5 doses in 24 hours 1. For an 8-month-old weighing approximately 8-9 kg, this would be about 80-135 mg per dose. It's also important to avoid aspirin due to the risk of Reye's syndrome in children with viral illnesses. Ibuprofen may also be used for children over 6 months at 5-10 mg/kg every 6-8 hours. Soft, cold foods like yogurt or applesauce may be better tolerated than solid foods during this time. Monitoring for signs of dehydration such as decreased wet diapers, dry mouth, or lethargy is crucial. If the child refuses to drink, has signs of dehydration, or symptoms worsen or persist beyond 10 days, medical attention should be sought promptly. Antibiotics are not effective against herpangina as it is caused by enteroviruses, most commonly Coxsackie virus. Regarding the use of magic mouthwash without lidocaine for herpangina, there is limited specific guidance in the provided evidence, but the focus remains on supportive care and symptom management as outlined. Topical oral sprays with antiviral drugs may be considered as part of symptomatic treatment, as suggested by the Chinese expert consensus on herpangina diagnosis and treatment 1. However, the specific dosage and duration for magic mouthwash in an 8-month-old with herpangina would need to be determined based on the formulation and ingredients of the mouthwash, considering the child's age, weight, and the need to avoid any potential harmful ingredients. Given the lack of detailed information on magic mouthwash in the provided evidence, the most appropriate recommendation is to follow the general principles of supportive care for herpangina, ensuring the child remains hydrated and comfortable, and seeking medical advice if symptoms worsen or do not improve within the expected timeframe. The study on the efficacy and safety of interferon α-2b spray for herpangina in children 2 suggests that local application of antiviral sprays can be effective, but this does not directly translate to the use of magic mouthwash without lidocaine. Therefore, the primary approach should prioritize hydration, pain management with acetaminophen or ibuprofen as appropriate, and monitoring for complications, with the understanding that herpangina is typically self-limiting.