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    Herpetic stomatitis

    Stomatitis - herpetic

    Herpetic stomatitis is a viral infection of the mouth that causes ulcers and inflammation. These mouth ulcers are not the same as canker sores, which are caused by a different virus.

    Causes

    Herpetic stomatitis is a contagious viral illness caused by Herpes virus hominis (also herpes simplex virus, HSV). It is seen mainly in young children. This condition is probably a child's first exposure to the herpes virus.

    An adult member of the family may have a cold sore at the time the child develops herpetic stomatitis. More likely, no source for the infection will be discovered.

    Symptoms

    • Blisters in the mouth, often on the tongue, cheeks, palate, gums, and a border between the lip (red colored) and the normal skin next to it
    • Decrease in food intake, even if the patient is hungry
    • Difficulty swallowing (dysphagia)
    • Drooling
    • Fever (often as high as 104 ¬įFahrenheit) may occur 1 - 2 days before blisters and ulcers appear
    • Irritability
    • Pain in mouth
    • Swollen gums
    • Ulcers in the mouth, often on the tongue or cheeks -- these form after the blisters pop

    Exams and Tests

    Your health care provider can usually diagnose this condition by looking at the mouth sores. Further tests are not usually done.

    Sometimes, special laboratory tests can help confirm the diagnosis.

    Treatment

    Treatment involves:

    • Acyclovir, which fights the virus causing the infection
    • A mostly liquid diet of cool/cold nonacidic drinks
    • Numbing medicine (viscous lidocaine) applied to the mouth if there is severe pain

    Lidocaine must be used with care because it can kill all feeling in the mouth. This may interfere with swallowing, and may lead to burns in the mouth or throat, or choking. There have been rare reports of death from overdose or misuse of lidocaine.

    Outlook (Prognosis)

    The child should recover completely within 10 days without medical treatment. Acyclovir taken by mouth may speed up recovery.

    Possible Complications

    Herpetic keratoconjunctivitis, a secondary herpes infection in the eye, may develop. This is an emergency and can lead to blindness. Dehydration may develop if the child refuses to eat and drink enough because of a sore mouth.

    When to Contact a Medical Professional

    Call your health care provider if your child develops a fever followed by a sore mouth, especially if they begin eating poorly (dehydration can develop rapidly in children).

    Prevention

    Approximately 90% of the population carries herpes simplex virus. It is difficult to prevent children from picking up the virus at some time during their childhood.

    Children should strictly avoid close contact with people who have cold sores (for example, no kissing parents who have active cold sores). Children should also avoid other children with herpetic stomatitis. They should not share utensils, glasses, or food with actively infected people.

    References

    Lingen MW. Head and neck. In: Kumar V, Abbas AK, Fausto N, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 16.

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    • Swollen gums

      illustration

      • Swollen gums

        illustration

      Self Care

        Tests for Herpetic stomatitis

          Review Date: 8/2/2011

          Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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