Primary herpetic gingivostomatitis is caused by an initial infection with theherpes simplex virus Type I and characterized by painful, erythematous, and swollengingivae.
Multiple tiny vesicles first present on the perioral skin, vermillion borderof the lips and the oral mucosa. The vesicles soon rupture into large, painfululcerated areas.
Systemic symptoms of fever, malaise, and cervical lymphadenopathy typically occur first, followed by the appearance of vesicles that progress to ulcers. The most common age of occurrence is 6 months to 6 years. Lesions heal spontaneously in 1 to 2 weeks, with the acute phase lasting 7 to 10 days.
Treatment usually includes rest, antipyretics, and analgesics. Palliative mouthrinses may be helpful in controlling the oral discomfort. Orabase® or petroleum jelly may be used as a protective barrier.
Dehydration may be a concern, especially in the younger patient.
Information to the caregiver should include explanation of the contagious aspects of this disease. Antibiotics are contraindicated, unless secondary infection is present. Steroids are also contraindicated.