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Herpetic gingivostomatitis in young children

Martha Ann Keels, DDS, PhD
Dennis A Clements, MD, PhD, MPH
Section Editors
Sheldon L Kaplan, MD
Ann Griffen, DDS, MS
Deputy Editor
Mary M Torchia, MD


Gingivostomatitis is the most common manifestation of primary herpes simplex virus (HSV) infection during childhood [1]. Primary herpetic gingivostomatitis is characterized by ulcerative lesions of the gingiva and mucous membranes of the mouth (picture 1), often with perioral vesicular lesions (picture 2).

The clinical features, diagnosis, management, and prevention of herpetic gingivostomatitis will be discussed here. Neonatal herpes simplex virus infection is discussed separately. (See "Neonatal herpes simplex virus infection: Clinical features and diagnosis" and "Neonatal herpes simplex virus infection: Management and prevention".)


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 [1]. 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 caused by herpes simplex virus type 1 [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 [1]. (See "Clinical manifestations and diagnosis of herpes simplex virus type 1 infection".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 15, 2017.
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