Herpes lesions on the gingiva. HSV-1 is predominantly responsible for oral, facial and ocular infections whereas HSV-2 is responsible for most genital and cutaneous lower herpetic lesions. Acute infection refers to the first invasion of the virus , and recurrent is when reactivation of the latent virus occurs. Most people acquire the virus via direct contact, it can enter the body by disrupting the integrity of skin, mucous membranes or enter via infected secretions such as saliva. The virus replicates once it has penetrated the epithelial cell , then it travels to the corresponding nerve ganglion i. At the nerve ganglion the virus enters a latent phase and remains dormant until it is reactivated.
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George AK. Email: moc. Copyright J. Int Oral Health Abstract Herpetic gingivostomatitis represents the most commonly observed clinical manifestation of primary herpes simplex virus HSV infection. HSV-1 has been associated with oro-labial disease, with most infections occurring during childhood, and HSV-2 with genital disease. An unusual case of acute herpetic gingivostomatitis AHGS that presented as extremely painful multiple ulcerations of the gingiva and hard palate in a year-old male patient is presented.
The association of HSV-2 in the etiology of oral lesions is highlighted. The clinical presentation, course, differential diagnosis and management of AHGS are discussed. Acute herpetic gingivostomatitis associated with herpes simplex virus 2: Report of a case. J Int Oral Health ;6 3 Primary human HSV-1 infection usually occurs in childhood and mostly presents as herpetic gingivostomatitis.
It is usually subclinical in early childhood and only a small percentage of patients develop an acute primary infection. This usually occurs in older children and consists of fever, malaise, headache, cervical lymphadenopathy and a vesiculo-ulcerative eruption on the peri-oral skin, vermilion or any intra-oral mucosal surface. Although HSV-2 is primarily responsible for most genital and cutaneous lower body herpetic lesions, it can also be the cause of primary herpetic gingivostomatitis.
The orogenital contact may allow either serotype to cause oral or genital lesions. The two forms of HSV have a similar structure but differ in antigenicity, and HSV-2 is reputed to be of greater virulence.
Symptoms such as cervical lymphadenopathy, malaise and low grade fever, can occur in the absence of any discrete clinical lesions. The general course of the infection is days, which is usually preceded by an incubation period of up to 26 days.
The unusual occurrence of HSV-2 in the oral cavity is highlighted. The excruciating and incapacitating nature of pain since 1 month had made this patient to abstain from work. The patient experienced severe pain radiating to his maxillary and temporal regions. On clinical examination an extremely tender ulcerated area was seen on the marginal and attached gingiva of the maxillary left molars.
The lesion extended in a band like manner mm wide, extending posteriorly from the mid buccal aspect of The area was covered by a yellowish white slough, and there was an erythematous halo surrounding the lesion Figure 1. There was bleeding on probing without any periodontal pockets. Radiographs revealed marginal alveolar bone loss. Palatal aspect of maxillary right premolars had irregular ulcers measuring less than a centimeter in diameter resembling a bunch of grapes Figure 2.
Patient complained of pain in the maxillary right buccal and palatal areas also Figure 3. Based on the history and clinical presentation a provisional diagnosis of herpes viral infection was made.
Acute Herpetic Gingivostomatitis Associated with Herpes Simplex Virus 2: Report of a Case
Oral Rashes which may be uncommon to some Sleeplessness In children, this kind of condition is misdiagnosed as the stage of the child known as teething episode or stage. It is known to be such because coincidentally, the disease appears when the child or infant is about to undergo his or her primary or first tooth eruption. The infants are at high risk for this condition because it is the time when their maternal antibody protection is lost and making them a high candidate for infection to invade such as this kind of infection cause disease. Herpetic Gingivostomatitis Diagnosis Normally, the person does not undergo test to be diagnosed with Herpetic Gingivostomatitis. Only physical examination and medical history may be required.
Your doctor will check your mouth for sores, the main symptom of the condition. More tests are not usually necessary. If other symptoms are also present such as cough , fever, and muscle pain , they may want to do more tests. In some cases, your doctor may take a culture swab from the sore to check for bacteria strep throat or viruses. Your doctor may also perform a biopsy by removing a piece of skin if they suspect other mouth sores are present. Gingivostomatitis sores usually disappear within two to three weeks without treatment.