Herpetic gingivostomatitis
| Herpetic gingivostomatitis | |
|---|---|
| Specialty | Infectious diseases, oral medicine  |
Gingivostomatitis (also known as primary herpetic gingivostomatitis) is a combination of gingivitis and stomatitis, or an inflammation of the oral mucosa and gingiva.[1] Herpetic gingivostomatitis is often the initial presentation during the first ("primary") herpes simplex infection. It is of greater severity than herpes labialis (cold sores) which is often the subsequent presentations. "Primary herpetic gingivostomatitis is the most common viral infection of the mouth".[2]
"Primary herpetic gingivostomatitis (PHGS) represents the clinically apparent pattern of primary herpes simplex virus (HSV) infection, since the vast majority of other primary infections are symptomless. PHGS is caused predominantly by HSV-1 and affects mainly children. Prodromal symptoms, such as fever, anorexia, irritability, malaise and headache, may occur in advance of disease. The disease presents as numerous pin-head vesicles, which rupture rapidly to form painful irregular ulcerations covered by yellow–grey membranes. Sub-mandibular lymphadenitis, halitosis and refusal to drink are usual concomitant findings."[3]
Symptoms
The symptoms can be mild or severe and may include:
- Sores on the inside of the cheeks or gums
- Fever
- General discomfort, uneasiness, or ill feeling
- Very sore mouth with no desire to eat
- Bad breath
Gingivostomatitis symptoms in infants may wrongly be dismissed as teething. "Coincidentally, primary tooth eruption begins at about the time that infants are losing maternal antibody protection against the herpes virus. Also, reports on teething difficulties have recorded symptoms which are remarkably consistent with primary oral herpetic infection such as fever, irritability, sleeplessness, and difficulty with eating."[5] "Younger infants with higher residual levels of antibodies would experience milder infections and these would be more likely to go unrecognized or be dismissed as teething difficulty."[6]
Causes
Gingivostomatitis generally affects children under the age of three and young adults. There are prodromal symptoms (fever, malaise, irritability, headache, vomiting, lymphadenopathy) 1–2 days prior to local lesions. Then small, yellowish vesicles form, which rupture quickly, resulting in shallow, round, discrete ulcers with erythematous halo. It affects both the free and attached mucosa. A generalized marginal gingivitis may precede the ulcers.
In addition, chronic elemental mercury poisoning can manifest with gingivostomatitis, in addition to neurologic (tremor, paresthesias) and psychiatric (forgetfulness, mood disturbances)symptoms.
Treatment
Treatment includes fluid intake, good oral hygiene and gentle debridement of the mouth. In healthy individuals the lesions heal spontaneously in 7–14 days without scar.
See also
References
- ^ "Gingivostomatitis" at Dorland's Medical Dictionary
- ^ "Oral Complications of Cancer and Its Management". By Andrew Davies, Joel Epstein. Oxford University Press, 2010. p195
- ^ "Herpes simplex virus infection, with particular reference to the progression and complications of primary herpetic gingivostomatitis", A. Kolokotronis, S. Doumas, Clinical Microbiology and Infection, Volume 12, Issue 3, pages 202–211, March 2006. http://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2005.01336.x/full
- ^ Dorfman, J. The Center for Special Dentistry.
- ^ "Herpetic gingivostomatitis and teething difficulty in infants". David L. King, William Steinhauer, Franklin Garcfa-Godoy, Cassandra J. Elkins. PEDIATRIC DENTISTRY MARCH/APRIL, 1992 VOLUME 14, NUMBER 2. p83
- ^ "Herpetic gingivostomatitis and teething difficulty in infants". David L. King, William Steinhauer, Franklin Garcfa-Godoy, Cassandra J. Elkins. PEDIATRIC DENTISTRY MARCH/APRIL, 1992 VOLUME 14, NUMBER 2. p84