Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
Primary herpetic gingivostomatitis
1.
2. It is a viral infection of the oral mucous
membrane caused by herpes simplex virus-
I(HSV-I).
Usually HERPES SIMPLEX VIRUS TYPE I
(HSV-1), and rarely TYPE II (HSV-2).
3. It is usually seen between the ages of 6 months
and 6 years
The onset of the disease is abrupt and is clinically
characterized by HIGH FEVER, HEADACHE,
MALAISE, ANOREXIA, IRRITABILITY,
BILATERAL SENSATIVE REGIONAL
LYMPHADENOPATHY, and SORE MOUTH
LESIONS.
The affected mucosa is RED and EDEMATOUS,
with numerous coalescing VESICLES, which
rapidly rupture, leaving painful small, round,
shallow ULCERS, covered by yellow fibrin
4. New LESIONS continue to develop during the first
3-5 days
The ulcers heal in 10-14 days.
Both movable and non movable oral mucosa may
be affected.
GINGIVAL LESIONS are almost always present,
resulting in enlargement and edematous and
painful erosions.
5. 1-3 days of fever , loss of appetite and myalgia
Cervical lymphadenopathy is present.
After the Primary infection the virus remains latent
in the nerve tissues.
If reactivation occurs it causes herpes labialis
(cold sore).
6. The virus targets the epithelial cells which show
“ballooning degeneration”
These cells are called Tzanck cells.
Infected cells fuse , forming multinucleated cells
and infected cells edema leads to formation of an
intraepithelial vesicles that rupture and develops a
secondary inflammatory response with a fibro
purulent exudate
Discrete ulceration have a central portion of acute
inflammation with exudate surrounded by
engorged blood vessels.
7. Established from patients history & clinical
findings.
HSV isolation by cell culture is the gold
standard.
Tzanck smear
BIOPSY
SEROLOGICAL TESTS.
9. 1. Local Applications:
*Using topical lignocaine and benzocaine
in mild cases.
*topical steroids like triamcinolone and
clobetasol application in severe cases.
2. Systemic therapy :
*pentroxifylline daspsone short bursts of
systemic steroids & thalidomide have been
used to reduce the no. of ulcers and
recurrence.