Infectious presentation with posterior pharyngeal ulcers and vesicles is most suggestive of which virus?

• A. Adenovirus
• B. Coxsackie Virus
• C. Enterovirus 71
• D. Herpes Simplex Virus

Answer: (B)

Posterior pharyngeal ulcers with vesicles point to a herpangina pattern, most classically caused by Coxsackie A virus, an enterovirus. The characteristic lesions sit on the soft palate and the posterior pharynx and often accompany fever and sore throat in children. Adenovirus tends to cause exudative pharyngitis and conjunctivitis rather than vesicular ulcers in the back of the throat. Herpes simplex virus usually produces vesicles in the anterior mouth and lips with gingivostomatitis rather than posterior pharyngeal ulcers. So, the posterior-pharyngeal vesicular ulcers best fit Coxsackie virus.