Herpetic gingivostomatitis

Revision as of 20:24, 10 September 2014 by Jesus Hernandez (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search

WikiDoc Resources for Herpetic gingivostomatitis

Articles

Most recent articles on Herpetic gingivostomatitis

Most cited articles on Herpetic gingivostomatitis

Review articles on Herpetic gingivostomatitis

Articles on Herpetic gingivostomatitis in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Herpetic gingivostomatitis

Images of Herpetic gingivostomatitis

Photos of Herpetic gingivostomatitis

Podcasts & MP3s on Herpetic gingivostomatitis

Videos on Herpetic gingivostomatitis

Evidence Based Medicine

Cochrane Collaboration on Herpetic gingivostomatitis

Bandolier on Herpetic gingivostomatitis

TRIP on Herpetic gingivostomatitis

Clinical Trials

Ongoing Trials on Herpetic gingivostomatitis at Clinical Trials.gov

Trial results on Herpetic gingivostomatitis

Clinical Trials on Herpetic gingivostomatitis at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Herpetic gingivostomatitis

NICE Guidance on Herpetic gingivostomatitis

NHS PRODIGY Guidance

FDA on Herpetic gingivostomatitis

CDC on Herpetic gingivostomatitis

Books

Books on Herpetic gingivostomatitis

News

Herpetic gingivostomatitis in the news

Be alerted to news on Herpetic gingivostomatitis

News trends on Herpetic gingivostomatitis

Commentary

Blogs on Herpetic gingivostomatitis

Definitions

Definitions of Herpetic gingivostomatitis

Patient Resources / Community

Patient resources on Herpetic gingivostomatitis

Discussion groups on Herpetic gingivostomatitis

Patient Handouts on Herpetic gingivostomatitis

Directions to Hospitals Treating Herpetic gingivostomatitis

Risk calculators and risk factors for Herpetic gingivostomatitis

Healthcare Provider Resources

Symptoms of Herpetic gingivostomatitis

Causes & Risk Factors for Herpetic gingivostomatitis

Diagnostic studies for Herpetic gingivostomatitis

Treatment of Herpetic gingivostomatitis

Continuing Medical Education (CME)

CME Programs on Herpetic gingivostomatitis

International

Herpetic gingivostomatitis en Espanol

Herpetic gingivostomatitis en Francais

Business

Herpetic gingivostomatitis in the Marketplace

Patents on Herpetic gingivostomatitis

Experimental / Informatics

List of terms related to Herpetic gingivostomatitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2].

Synonyms and keywords: Gingivostomatitis, oral herpes.

Overview

Gingivostomatitis (also known as primary herpetic gingivostomatitis or orolabial herpes) 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

File:Herpes Gingivalis.tiff
Herpes lesions on the gingiva.[4]

The symptoms can be mild or severe and may include:

  • Not able to chew or swallow
  • Sores on the inside of the cheeks or gums
  • Fever
  • General discomfort, uneasiness, or ill feeling
  • Very sore mouth with no desire to eat
  • Halitosis (bad breath)

Differential Diagnosis

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]

Gingivostomatitis must also be differentiated from herpangina, another disease that also commonly causes ulcers in the oral cavity of children, but is caused by the Coxsackie A virus rather than a herpes virus.[7] In herpangina, ulcers are usually isolated to the soft palate and anterior pillar of the mouth.[7] In herpetic gingivostomatitis, lesions can be found in these locations, but they are almost always accompanied by ulcerations on the gums, lips, tongue or buccal mucosa and/or by hyperemia, hypertrophy or hemorrhage of the gums.[7]

Causes

Herpes Stomatitis is caused by Herpes hominis virus, type I and II infect oral mucosa but type I is more common. 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 scarring.

Physical examination

Gallery

Head

Oral cavity

References

  1. Template:DorlandsDict
  2. "Oral Complications of Cancer and Its Management". By Andrew Davies, Joel Epstein. Oxford University Press, 2010. p195
  3. "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
  4. Dorfman, J. The Center for Special Dentistry.
  5. "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
  6. "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
  7. 7.0 7.1 7.2 PARROTT, RH (August 1954). "Clinical and laboratory differentiation between herpangina and infectious (herpetic) gingivostomatitis". Pediatrics. 14 (2): 122–9. PMID 13185685. Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)