Types of herpes simplex virus
There are 8 types of herpes simplex virus which affect human beings.
Type 2 herpes simplex virus/ genital herpes : can cause severe oropharyngeal infection and it is usually transmitted through sexual contact.
Type 3 herpes varicella zoster virus: causes chicken pox among children
Type 4 herpes virus (Epstein Barr virus infection): which produce lesions in the mouth and oropharynx. Clinical features of the infection are fever, weakness, rashes, sore throat, swollen lymph nodes.
Type 5 herpes simplex virus : associated with cytomegalovirus infection.
Type 6 and type 7 herpes virus : They might be associated with Roseola disease which are commonly seen in children.
Type 8 herpes virus is associated with Kaposi sarcoma and is transmitted through sexual contact. Patients with Kaposi sarcoma are presented with erythematous patches on the lower part of body.
PRIMARY HERPETIC GINGIVOSTOMATITIS
Primary herpetic gingivostomatitis is a highly contagious infection caused by the herpes simplex Type I virus. It is seen mainly in young children especially between 12 and 18 months of age.
The virus is transmitted via saliva or other body fluids.
Prodomal symptoms (sets of symptoms that might indicate the start of a disease)
– Difficulty in eating and drinking.
Their gums can become very red and swollen/oedematous. Small vesicles will form around the gums or other parts of the oral cavity. They will break down rapidly within hours to form painful ulcers (around 3mm in size)
Management of primary herpetic gingivostomatitis:
The objectives of treating patients with primary herpetic gingivostomatitis is to relieve painful symptoms, and to provide supportive care (to ensure patients have adequate rest, fluid and nutrition)
– It is important to maintain fluid intake during this period to prevent dehydration. Hospital admission is required for those who cannot take oral fluids orally.
– Analgesics such as paracetamol are normally prescribed to provide pain relief.
– Avoid prescribing topical steroid medications as they will permit the spread of viral infection.
– For patients who have severe ulcers, topical anaesthetic and coating agents can be placed over the ulcers.
– Antiviral drugs such as acyclovir are used to treat oral herpes infection which occur in immunocompromised patients.
– Antibiotics are unhelpful in treating primary herpetic gingivostomatitis.
Primary herpetic gingivostomatitis is a self limiting disease whereby patients will have spontaneous remission. Ulcers will heal spontaneously without leaving a scar within 10 to 14 days.