Oral herpes is a primary infection with the Herpes simplex virus (HSV). In many children, initial infection with HSV is mild and either goes unnoticed or is mistakenly attributed to teething. However, the infection can cause a condition called herpetic gingivostomatitis or herpetic stomatitis. This condition is characterized by painful blister-like sores called vesicles throughout the inside of the mouth. Herpetic stomatitis usually occurs in children between the ages of 6 months and 5 years, though it can occur in older children.
Fever
Fever is a common symptom of herpetic stomatitis and may be present before the vesicles appear in the mouth. The fever typically breaks in 3 to 7 days.
Sore Throat
A sore throat may present a day or two before the mouth lesions appear.
Painful Mouth Sores
The vesicles of oral herpes can occur anywhere inside the mouth, including the throat, palate, tongue, gums and insides of the cheeks. They are usually numerous and quickly merge to form painful, ulcerated sores. The sores typically heal in 10 to 14 days.
Swollen Gums
With herpetic stomatitis, the gums are generally swollen and red; they may bleed a small amount.
Bad Breath
A foul breath odor accompanies herpetic stomatitis. Difficulty brushing the teeth because of the painful mouth sores compounds this symptom.
Swollen Lymph Nodes
Children with herpetic stomatitis may have swollen glands (lymph nodes) in the neck and under the chin.
Eating and Swallowing Difficulties
The mouth and throat lesions present in herpetic stomatitis are quite painful, especially when they begin to ulcerate. Eating and swallowing may become so painful that the child refuses to eat or drink despite being hungry and thirsty. Young children often drool because they are avoiding the pain of swallowing.
Irritability
Although herpetic stomatitis is not life threatening, it is a miserable thing to have--especially for a young child. The fever, mouth and throat pain, and difficulty eating and resultant hunger combine to create what is commonly a high level of irritability.
References
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D., John E. Bennett, M.D., Raphael Dolin, M.D., Editors; 2004
- "Clinical Dermatology: A Color Guide to Diagnosis and Therapy"; Thomas P. Habif, M.D.; 1996
- "Harrison's Principles of Internal Medicine, 16th Edition"; Anthony S. Fauci, M.D., Eugene Braunwald, M.D., J. Larry Jameson, M.D., Ph.D., Dennis L. Kasper, M.D., Stephen L. Hauser, M.D., Dan L. Longo, M.D., Editors; 2004
- Merck Manual: Herpes simplex virus infections
- Medline Plus: Herpetic stomatitis
