Vesicles or ulcers on the pharynx suggest which etiologic category?

• A. Bacterial
• B. Viral
• C. Fungal
• D. Allergic

Answer: (B)

Vesicles or ulcers in the pharynx are most consistent with a viral infection because viruses commonly cause mucosal vesiculation that ruptures into painful ulcers in the oropharynx. Classic examples include enteroviruses like Coxsackie A, which cause herpangina or hand–foot–mouth disease with characteristic vesicles and ulcers in the throat, and herpes simplex virus, which can cause primary herpetic stomatitis with painful oral ulcers and vesicles.

Bacterial pharyngitis tends to present with sudden sore throat, fever, tender anterior cervical adenopathy, and often tonsillar exudates rather than discrete vesicles. Fungal infections such as candidiasis produce white plaques that can wipe off, not discrete vesicular ulcers. Allergic reactions do not typically produce vesicles or ulcers in the pharynx.