Acute herpetic gingivostomatitis (AHG) is a viral infection of the oral mucosa caused by the herpes simplex virus type 1. It occurs most frequently in infants and children under 6 years old and presents with diffuse erythema and edema of the gums, as well as clusters of vesicles dispersed throughout the mouth, lips, palate, and tongue. The symptoms include generalized oral soreness and fever, and the full course of the disease is typically 7-10 days. After the primary infection subsides, the virus can remain latent in nerve tissues and potentially reactivate to cause cold sores.

1. ACUTE HERPETIC
GINGIVOSTOMATITIS
Uzma Jan
3rd year B.D.S

2. AHG is a viral infection of the oral mucous membrane caused by
herpes simplex virus-I(HSV-I).
Occurs most frequently in infants & Children younger than 6 years .

3. CLINICAL FEATURES
 ORAL SIGNS :
 Appears as a diffuse shiny
erythematous edema & gingival
bleeding.
 Discrete spherical clusters of vesicle
dispersed in different areas (labial
buccal mucosa hard palate pharynx and
tongue)
 Course of disease is 7-10 days
 SYMPTOMS:
 Generalized soreness of oral cavity
 Ruptured vesicles sensitive t0 touch
thermal changes and food

4. EXTRA ORAL & SYSTEMIC SIGN &
SYMPTOMS
 1-3 days of fever , loss of appetite and myalgia
 Cervical lymphadenopathy is present.

5.  After the Primary infection the virus remains latent in the nerve tissues.
 If reactivation occurs it causes herpes labialis (cold sore).

6. HISTOPATHOLOGY
 The virus targets the epithelial cells which show “ballooning
degeneration”
 These cells are called Tzanck cells.
 Infected cells fuse , forming multinucleated cells and IC edema leads to
formation of an intraepithelial vesicles that rupture and develops a sec.
inflammatory response with a fibro purulent exudate
 Discrete ulceration have a central portion of acute inflammation with
exudate surrounded by engorged blood vessels.

7. DIAGNOSIS
 Established from pts history & clinical findings.
 HSV isolation by cell culture is the gold standard.
 Tzanck smear

8. D/D
 Necrotizing Ulcerative Gingivitis
 Erythema multiforme
 Stevens-Johnson Syndrome
 Apthous Stomatitis (canker sores)

9. COMMUNICABILITY
 Contagious

10. TREATMENT
 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.