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Gingivostomatitis herpeticaB00.2
Synonym(s)
DefinitionThis section has been translated automatically.
Manifestation of a primary infection with the herpes simplex virus type 1 in the form of an acutely occurring aphthous oral mucosa inflammation. Neonatal manifestations usually occur from mother to child, more rarely through infectious contacts. Otherwise, droplet infections (sneezing, coughing, speaking) or contact with infectious saliva occur.
ManifestationThis section has been translated automatically.
Almost exclusively occurring in infants up to the age of 5 years. Less frequently in adulthood (see fig.).
Clinical featuresThis section has been translated automatically.
After unspecific prodromes (incubation period 3-10 days), acute onset of numerous, aphthous, locally confluent erosions and shallow ulcerations of the oral mucosa, preferably in the vestibule oris.
Gingivitis with inflammatory reddened, swollen, slightly bleeding mucosa.
Partially pronounced general symptoms such as fever, exhaustion, vomiting.
Painful regional lymphadenitis.
Gingivostomatitis herpetica in adults is rare. It is observed mainly in immunosuppressed patients.
Differential diagnosisThis section has been translated automatically.
Erythema exsudativum multiforme: usually combined with multiforme skin manifestations.
Herpangina Zahorsky due to Coxsackie A virus infection.
Hand-foot-mouth disease: always combined with blistering of the hands/feet.
Complication(s)This section has been translated automatically.
Secondary bacterial infection, involvement of fingers, upper lip, nasal entrance (further inoculation of the virus by smear infection).
Complications: Rare meningoencephalitis herpetica
External therapyThis section has been translated automatically.
Mouth rinses with stomatological agents such as chamomile extracts (e.g. Kamillosan), 5% dexpanthenol (e.g. Bepanthen solution, R066 ) or analgesic preparations (e.g. Acoin solution or periodontal mouth ointment).
Healing usually within 1 week.
Internal therapyThis section has been translated automatically.
Virustatics such as aciclovir (e.g. Zovirax): 5x200mg/day for 10 days; for herpes encephalitis 3x10 mg/kg bw/day i.v. for 2 weeks.
Alternative: Famciclovir (Famvir®): 3x250 mg/day for 5 days (oral).
Age alternative: Valaciclovir (Valtrex® ): 2x500mg/day for 10 days (orally).
To prevent secondary infections, broad-spectrum antibiotics such as doxycycline (e.g., Vibravenous) initially 200 mg/day i.v., subsequent days 100 mg/day i.v. Children 4 mg/kg bw/day i.v., if necessary.
High-caloric liquid nutrition (e.g. Meritene). Parenteral fluid administration if necessary.
Reminder. Ensure sufficient fluid intake!
Progression/forecastThis section has been translated automatically.
Favorable in localized disease; usually scarless healing within 1 week.
Note(s)This section has been translated automatically.
The infectious disease is contagious. The virus excretion usually lasts for 7 days in untreated persons (max. 12 days). During this time contact with other small children should be avoided.
An analogous clinical picture can also appear in girls and young women as vulvovaginitis herpetica.
LiteratureThis section has been translated automatically.
- Chen CK edt al (2012) Herpetic gingivostomatitis with severe hepatitis ina previously healthy child. J Microbiol Immunol Infect 45: 324-325
- Mohan RP et al (2013) Acute primary herpeticgingivostomatitis. BMJ Case Rep doi:10.1136/bcr-2013-200074
- Nevet A et al (2014) C-Reactive protein levels inchildren with primary herpetic gingivostomatitis. Isr Med Assoc J 16:700-702
- Podder I (2014) Herpetic gingivostomatitis. Indian Pediatrist 51:764