Herpetic Stomatitis

🦷 Herpetic Stomatitis

Herpetic stomatitis is a painful viral infection of the mouth caused by the Herpes Simplex Virus (HSV), usually type 1 (HSV-1). It most commonly affects young children but can also occur in adults.


🧬 Cause:

  • Primary Herpes Simplex Virus Type 1 (HSV-1) infection
  • Spread through saliva, direct contact with infected lesions, or contaminated objects
  • Often occurs during first exposure to HSV in childhood

🩺 Types:

  1. Primary herpetic gingivostomatitis
    • The initial infection, usually in children ages 6 months to 5 years
    • More severe than future flare-ups
  2. Recurrent herpetic stomatitis
    • Reactivation of HSV (often presents as cold sores on lips or inside the mouth)

🧒 Who’s at Risk?

  • Young children who haven’t been exposed to HSV
  • Immunocompromised individuals

💥 Symptoms (Primary Infection):

  • High fever (often the first sign)
  • Irritability, fatigue, and drooling
  • Painful blisters or ulcers on the tongue, lips, gums, and inside of cheeks
  • Red, swollen gums (gingivitis)
  • Loss of appetite or refusal to eat/drink
  • Foul breath
  • Swollen lymph nodes in the neck

Symptoms may last 7 to 14 days, with ulcers healing without scarring.


🔍 Diagnosis:

  • Clinical examination based on appearance and age
  • Viral culture, PCR, or Tzanck smear (in unclear cases)
  • HSV antibody tests (less useful for acute diagnosis)

💊 Treatment:

  • Supportive care (most important):
    • Fluids to prevent dehydration
    • Pain relief (acetaminophen, ibuprofen)
    • Mouth rinses or numbing gels (e.g., lidocaine – with caution)
  • Antiviral medication (e.g., acyclovir):
    • May be prescribed if started within 72 hours of symptom onset
    • Shortens duration and severity of illness

Encourage soft, bland foods and cold fluids (e.g., yogurt, ice pops).

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