ACUTE HERPETIC GINGIVOSTOMATITISUzma Jan 3rd year B.D.S

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 .

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

EXTRA ORAL & SYSTEMIC SIGN & SYMPTOMS

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).

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.

DIAGNOSIS

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

D/D

Necrotizing Ulcerative Gingivitis Erythema multiforme Stevens-Johnson Syndrome Apthous Stomatitis (canker sores)

COMMUNICABILITY

Contagious

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.