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Dr Mike Martin. University of Liverpool. Derweb.

Herpetic Stomatitis

This is a contagious viral infection, which produces ulceration and inflammation of the gums.

Causes
Herpetic stomatitis is caused by Herpes Simplex Virus and is seen in children.

Incidence
Infection within the first 6 months is rare due to passive protection from antibody transferred across the placenta. After this period the infant is susceptible and subclinical infection is very common.

The primary infection occurs between 9 months and 5 years and may result in an acute gingivostomatitis.

Primary infections can be seen later in childhood.

Symptoms
Clinical features include:

  • Irritability and refusal of food due to difficulty in swallowing.
  • High fever.
  • Vesicles on the tongue, buccal mucosa, gums and skin around the mouth.The ulcers are very painful.
  • The mucosa becomes red, swollen and bleeds easily.
  • The vesicles breakdown to form ulcers.
  • Secondary bacterial infection may occur with enlarged lymphnodes and difficulty in swallowing.
  • It is self-limiting and lasts between 7 to 10 days.

Prevention
Approximately 80% of the population carry the HSV which makes it difficult to prevent children contracting the virus. Parents should avoid kissing their children when they have a cold sore. Also avoid sharing glasses, food and utensils.

Test
Can be diagnosed by its appearance.

Treatment
The patient can recover without any medication within 10 days.

Acyclovir may be used. Topical lidocaine is suitable for severe pain.

As the childs mouth will be sore, a liquid diet will be needed.

Complications
A secondary herpes infection of the eye may occur (Herpetic Keratoconjunctivitis).

A sore mouth may also lead to dehydration if the child refuses food and drink.

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