Herpes gingivostomatitis: Difference between revisions

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==Management==
==Management==
''Treatment does not affect dormant virus in nerve ganglions → recurrent disease remains possible''
{{{HSV-1 treatment}}
*Antiviral drug
 
**[[Acyclovir]] 40-80mg/kg PO divided in 3-4 doses for 5-7 days
***Can also be used as a cream or oral suspension (swish and swallow)<ref name="Mohan" />
**Valacyclovir (significantly higher bioavailability than acyclovir)
**Famciclovir
*Analgesia (e.g. Acetaminophen and/or Ibuprofen)
*Analgesia (e.g. Acetaminophen and/or Ibuprofen)
*PO intake is important
*PO intake is important

Revision as of 21:26, 25 April 2016

Background

  • Primary HSV-1 infection of lips, gingiva, and tongue
    • HSV-2 associated with genital disease
  • Usually occurs in childhood[1]
  • 90% of population is seropositive by age 40[1]
Herpes gingivostomatitis of mouth

Clinical Features

  • Prodrome of fever, myalgias, and cervical adenopathy[2]
  • Painful vesicular and/or ulcerative lesions of mucocutaneous areas (non-keratinized mucosa)
    • Can be extremely painful and → odynophagia
  • Lasts approx 1-4 weeks without treatment, course shortened with treatment

Differential Diagnosis

Herpes Simplex Virus-1

Diagnostic Evaluation

  • Clinical diagnosis, based on history and physical exam
  • Available laboratory studies (not required for diagnosis)[2]:
    • Viral culture (gold standard)
    • Direct immunofluorescence
    • Tzanck smear (poor specificity)

Management

{Template:HSV-1 treatment

  • Analgesia (e.g. Acetaminophen and/or Ibuprofen)
  • PO intake is important
    • Consider viscous lidocaine before meals[1]

Disposition

  • Discharge

See Also

External Links

References

  1. 1.0 1.1 1.2 George AK, Anil S. Acute Herpetic Gingivostomatitis Associated with Herpes Simplex Virus 2: Report of a Case. Journal of International Oral Health : JIOH. 2014;6(3):99-102.
  2. 2.0 2.1 Mohan RPS, Verma S, Singh U, Agarwal N. Acute primary herpetic gingivostomatitis. BMJ Case Reports. 2013;2013:bcr2013200074. doi:10.1136/bcr-2013-200074.