Herpetic gingivostomatitis in young children
- Martha Ann Keels, DDS, PhD
Martha Ann Keels, DDS, PhD
- Associate Professor of Pediatric Dentistry
- Duke University Medical Center
- Dennis A Clements, MD, PhD, MPH
Dennis A Clements, MD, PhD, MPH
- Professor of Pediatrics
- Duke University
- Section Editors
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
- Ann Griffen, DDS, MS
Ann Griffen, DDS, MS
- Section Editor — Pediatric Oral Health
- Professor of Pediatric Dentistry
- Ohio State University
Gingivostomatitis is the most common manifestation of primary herpes simplex virus (HSV) infection during childhood . Primary herpetic gingivostomatitis is characterized by ulcerative lesions of the gingiva and mucous membranes of the mouth, often with perioral vesicular lesions (picture 1).
The clinical manifestations of mucocutaneous herpes simplex virus type 1 (HSV-1) disease are due to tissue destruction, a direct consequence of viral replication and cell lysis . Inoculation of HSV-1 at mucosal surfaces or skin sites permits entry of the virus into sensory and autonomic nerve endings through which it is transported to the cell nuclei (eg, the trigeminal ganglion), where it remains latent. Reactivation results in recurrent herpes simplex virus disease (eg, herpes gingivostomatitis, herpes labialis). (See "Pathogenesis of herpes simplex virus type 1 infection".)
Herpetic gingivostomatitis is almost always caused by herpes simplex virus type 1 .
Primary herpetic gingivostomatitis typically occurs in children between six months and five years of age, but it can occur in older children and adolescents . (See "Clinical manifestations and diagnosis of herpes simplex virus type 1 infection".)
Herpetic gingivostomatitis occurs throughout the year, with no particular seasonal distribution . In a retrospective review at a single institution, herpes simplex virus (HSV) gingivostomatitis was diagnosed in 1.6 per 10,000 emergency department visits and 5.6 per 10,000 hospital admissions .
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- Incubation period
- CLINICAL FEATURES
- DIFFERENTIAL DIAGNOSIS
- Natural history
- Indications for hospitalization
- Supportive care
- - Fluid intake
- - Pain control
- - Topical therapies
- Oral acyclovir
- - Indications
- - Dose and duration
- - Adverse effects
- Topical antivirals
- Immunocompromised children
- Antibiotic therapy
- Child care
- SUMMARY AND RECOMMENDATIONS