Acute herpetic stomatitis: causes, symptoms, treatment. Alternative methods of treatment of herpetic stomatitis

Are you familiar with the sensation of burning and itching on the lips? Or the appearance of unexpectedly - unexpectedly bubbles on the skin of the face and lips? 95% of the people on the planet know what I'm talking about. True, not everyone pays due attention to these things. Perhaps, let's start with the fact that any inflammation of the oral mucosa is called STOMATITIS. But in this article we will talk about the most common disease in the world as a whole, in the common people called - HERPES. Namely, consider herpetic stomatitis, etiology, pathogenesis, clinic and treatment of this disease.

ETIOLOGY OF HERPETIC STOMATITIS

The etiology of herpetic stomatitis is simple. There is a virus - there is a disease. The herpetic stomatitis virus belongs to the family HERPESVIRIDAE. This family includes about 80 various viruses, and, attention, 8 of which are the causes of human disease. Herpetic stomatitis is caused by a virus herpes simplex 1st type (HSV-1), and if it was congenital infection or intrauterine (neonatal) - then this infection occurred with the herpes simplex virus type 2 (HSV - 2).

It would seem that the virus is simple - the infection is simple. But the herpes simplex virus itself is very cunning and insidious. This virus, the herpes simplex virus, came up with 4 ways for itself to enter the human body:

• Airborne (therefore, it is recommended to avoid people with a visible manifestation of the virus);
• Contact (it is unlikely that lips affected by herpes give pleasant kisses);
• Transplacental (that is, from mother to child);
• Transfusion (with blood transfusion).

PATHOGENESIS OF HERPETIC STOMATITIS

The pathogenesis of herpetic stomatitis is quite complex, not fully understood. It is not fully explained what factors dissolve the inner shell of the virus, what viral factors allow it to penetrate into DNA - human cells, and why the virus, when it is not active (that is, not clinical manifestations) is not treatable.
However, scientists believe that at the time of infection, the herpes simplex virus attaches to specific receptors on the cell membrane (the cell that is sensitive to HSV). Then the fusion of the cell membrane and the outer shell of the virus occurs. At the time of this penetration cell membrane cells are not damaged, and the virus, as it were, buds inside. Then cellular enzymes work, those that dissolve the inner shell of the virus and the “naked” virus penetrates the DNA of the host cell. And in this state, the herpes simplex virus can be long time until triggers kick in.

FACTORS PROVOKING RECURRENCE OF HERPETIC STOMATITIS

Factors provoking the recurrence of herpetic stomatitis are large group. In principle, herpes can be triggered by anything, from climate change and time zone to SARS and other infections. AND yes, to the group Factors provoking recurrence of herpetic stomatitis include:

• Any change in body temperature (hypothermia is more like the herpetic stomatitis virus);
• Decreased immunity (any infection, etc.);
• Mucosal and skin injury;
• Stress, overwork or overexertion;
• The use of alcoholic beverages;
• Smoking;
• Menstruation;
• Change of climate and time zone;
• Taking medication.

As can be seen from the lists, there are many factors, and the virus is just waiting for the body to give up. Children from 6 months to one year are sick due to the termination of the work of protective proteins from the mother. Therefore, let's talk about the prevention of herpetic stomatitis.

PREVENTION OF HERPETIC STOMATITIS

Prevention of herpetic stomatitis should be carried out not only after a person had manifestations of herpes, but also before birth. That is, work should be carried out with parents as an obstetrician - gynecologist, and a dentist. by the most simple rules prevention of herpetic stomatitis are:

• The use of masks;
• Thorough hand hygiene;
• Uses individual funds hygiene;
• Individual dishes, towels, etc.;
• Kissing bans;
• Prohibition on tasting food;
• General cleaning of the premises;
• ventilation;
• Hardening of the body;
• Complete nutrition;
• Physical activity;
• Timely treatment of common diseases.

But if you or your child has come into contact with a person who suffers from herpetic stomatitis, it is recommended to lubricate the oral mucosa for 5 days antiviral ointments(let's say acyclovir) or prevention may be taking interferon.

SYMPTOMS OF HERPETIC STOMATITIS

Knowing the symptoms of herpetic stomatitis is very helpful for timely treatment. That is, there is an opportunity to prevent a bright clinical picture.

Symptoms of herpetic stomatitis:

• Burning;
• Unpleasant sensation on the mucous membrane of the lips;
• There may be chills;
• Weakness;
• Malaise;
• Headache.

These are, you know, such common symptoms - the precursors of the appearance of herpes. However, in the development of the disease of herpetic stomatitis, 4 stages are distinguished, each of which is characterized by its own symptoms.

STAGES OF DEVELOPMENT OF HERPETIC STOMATITIS

The first period or the first stage is incubation period . This period is NOT clinically manifested.

The second stage of the development of the disease - prodrome (it is at this stage that the general symptoms of herpetic stomatitis are observed. Remember that the symptoms may vary depending on the severity of the disease, it is written about it below)

Third stage - period of development - he is the period of rashes.

Fourth stage - fading period - restoration of the mucous membrane, skin, well-being also normalizes.

CLASSIFICATION OF HERPETIC STOMATITIS

The classification of herpetic stomatitis includes:

• Acute herpetic stomatitis;
• Chronic recurrent herpetic stomatitis;
• Herpetic geometric glossitis;
• Herpes of gladiators;
• Acute herpetic infection in newborns;
• Chronic herpetic infection with manifestation in the oral cavity in some immunodeficiency states.

Herpetic stomatitis is also:

• Acute (appeared for the first time);
• Chronic.

ELEMENTS OF HERPETIC STOMATITIS

There is a certain order in which the elements of a herpetic lesion appear on the red border of the lips.

First, a papule appears (a painless seal in the form of a whitish nodule), then a vesicle with contents appears (the contents may be transparent, it may be cloudy), after the vesicle a crust appears, the crust has disappeared, and a spot will appear in its place. And then everything is restored.

When it is the mucous membrane of the oral cavity that is affected, there are some features. It all starts with a spot, which then turns into a vesicle (the vesicles, as she said, can be either with transparent contents or cloudy), after the vesicle, erosion occurs (hyperemic, painful, sensitive to stimuli, an open area of ​​\u200b\u200bmucosa), which will turn into aphthae ( formation with a halo of redness along the edge of the element, whitishness inside). And then again a stain and recovery.

ACUTE HERPETICH E STOMATITIS

Acute herpetic stomatitis occurs for the first time. And the severity of the infection (from mild to severe) depends, firstly, on the very aggressiveness of the virus, and secondly, on the host's immunity. Therefore, in some cases, the infection goes away on its own, as if “self-limitingly”: after two weeks, a visible clinical recovery occurs, and the incubation period begins again. In other cases, when the immune defense is not very strong, the virus can spread to other organs and systems, leading to generalization. herpetic infection.

Consider each form of acute herpetic stomatitis.

1. Mild form of acute herpetic stomatitis

A mild form of herpetic stomatitis in the prodromal period is characterized by:

• slight increase body temperature (no more than 37 - 37.5 degrees)
• development of catarrhal gingivitis;
• enlarged lymph nodes;
• duration no more than 1 - 2 days.

A mild form of herpetic stomatitis during development is characterized by:

• the appearance of single elements of the lesion (! the number of bubbles does not exceed the number 5!);
• preservation of hyperemia of the oral mucosa;
• retention of enlarged lymph nodes.
• The duration of the period is 1-2 days.

A mild form of herpetic stomatitis during the extinction period is characterized by:

• By reducing all elements of the lesion in size, they heal (epithelialization),
• Normalization of the size of the lymph nodes;
• Normalization of body temperature;
• Reduction of mucosal hyperemia
• The period is longer.

2) The average form of herpetic stomatitis

The average form of herpetic stomatitis in the prodromal period is characterized by:

• The appearance of weakness, sleep disturbances, appetite;
• An increase in body temperature up to 37.5 degrees;
• Enlarged lymph nodes in size.

The average form of herpetic stomatitis during the development period is characterized by:

• Chills, weakness, headache;
• An increase in body temperature up to 39 degrees;
• The presence of up to 25 elements of damage;
• Generalized catarrhal gingivitis;
• bleeding gums;
• Increased salivation.

The average form of herpetic stomatitis during the extinction period is characterized by:

• Recovery general well-being;
• Normalization of the size of the lymph nodes;
• Healing of lesions.

3) Severe form of acute herpetic stomatitis

The severe form of acute herpetic stomatitis is less common than other forms and occurs in people with very weak immunity. Most often with severe immunodeficiencies.

A severe form of herpetic stomatitis in the prodromal period is characterized by:

• Apathy;
• headache;
• Skin can be seen muscle changes type of hyperesthesia;
• Changes in the cardio- vascular system type of bradycardia, tachycardia, hypotension;
• Nausea, vomiting, bleeding from the nose and throat;
• Inflammation of the lymph nodes not only in the jaw area, but also on the neck.

A severe form of herpetic stomatitis during the development period is characterized by:

• Body temperature over 39 degrees;
• The oral mucosa is edematous and hyperemic;
• Dry lips are noted, cracking is possible;
• The number of elements of defeat is more than 100!
• Ulcerative gingivitis;
• Increased salivation with blood.

A severe form of herpetic stomatitis during the period of extinction depends on the body's immunity and often complete and high-quality healing does not occur.

CHRONIC RECURRENT HERPETIC STOMATITIS

Like acute herpetic stomatitis, chronic recurrent herpetic stomatitis goes through 4 stages of the disease and has three forms. The only difference is that the form in chronic recurrent herpetic stomatitis is determined not by the number of lesions (there are up to 5, up to 25 or more than 100), but by the frequency of occurrence per year.

Mild form of chronic recurrent herpetic stomatitis characterized by the occurrence of lesions 1 - 2 times in 3 years;

The average form of chronic recurrent herpetic stomatitis characterized by the occurrence of lesions 1 - 2 times a year;

Severe form of chronic recurrent herpetic stomatitis characterized by the occurrence of lesions 4 or more times a year.

In chronic recurrent herpetic stomatitis, single or group elements of the lesion are detected, most often in the form of small vesicles, which then appear, forming erosion. The mucosa is edematous and hyperemic. With a severe degree of chronic recurrent herpetic stomatitis, a deterioration in the general well-being of the patient is added, headache, weakness, body temperature over 39 degrees.

DIFF DIAGNOSIS OF HERPETIC STOMATITIS

Differential diagnosis of herpetic stomatitis is carried out with chronic aphthous stomatitis, with multiform exudative erythema, With pemphigus vulgaris.

If we compare herpetic stomatitis and chronic aphthous stomatitis, then in both lesions there are aphthae. However, with aphthous stomatitis, they are solitary, rounded, covered with a whitish coating and surrounded by a halo of hyperemia, there is no catarrhal gingivitis, The lymph nodes not enlarged and absent fever body.

The difference between herpetic stomatitis and exudative erythema begins with the time of year. Most often, erythema occurs in the autumn - spring time and immediately begins hard. That is, a total lesion of the mucous membrane, hyperemia, and edema are characteristic. Erosions and ulcers are large, massive hemorrhagic crusts on the red border of the lips, cracks. The general condition also suffers: body temperature is more than 40 degrees, weakness, malaise, multiple cyanotic spots (cockades) on the skin of the hands.

The difference with pemphigus vulgaris is that with pemphigus there are little painful erosions located on a visually healthy oral mucosa.

TREATMENT OF HERPETIC STOMATITIS

Treatment of herpetic stomatitis can be general, it can be local. Depending on the severity of herpetic stomatitis given treatment can be combined.

General treatment is reduced to the appointment:

• High-calorie diet, drinking plenty of warm water;
• Antiviral drugs orally, intravenously, or intramuscularly for moderate to severe forms of the disease;
• Desensitizing therapy is carried out (diphenhydramine, suprastin);
• General strengthening therapy (vitamin C up to 2.0 g per day, calcium preparations, means to increase the immune defense of the body such as ginseng, eleutherococcus)
• As an analgesic, antipyretic and anti-inflammatory agent, sodium salicylate can be used;
• Gamma globulin, immunal, lysozyme are prescribed in cycles;
• When choosing a tactic general treatment you need to correctly determine the form of the disease!

Local treatment is reduced to rinsing the mouth with an antiseptic (can be combined with an anesthetic), applications of antiviral ointments, gels, not only antiviral, but also stimulating a local immune response, enzyme preparations, preparations for accelerating epithelialization, astringent preparations.

In the interrecurrent period, they resort to the use of acyclovir 200 mg daily from 2 to 5 times a day for 1 to 3 years.

Be attentive to yourself and others, do not get sick! Thanks for reading!

The article was written by N. Shidlovskaya. Please, when copying the material, do not forget to indicate the link to the current page.

Herpetic Stomatitis-Etiology Pathogenesis Clinic updated: April 30, 2018 by: Valeria Zelinskaya

Briefly about herpetic stomatitis

The disease is a disease that affects the mucous membrane of the oral cavity and is caused by the herpes simplex virus. It occurs in children from six months to three years. The child becomes infected by airborne infection from a virus carrier or a sick person, as well as through sexual contact. As a rule, a weakened immune system prepares the soil for the disease.

Classification of herpetic stomatitis

According to the course of the disease, there are:

• spicy;
• chronic relapsing.

Based on severity:

• light;
• moderate;
• heavy.

Clinical picture of herpetic stomatitis

In all of the above forms, both acute and recurrent herpes can occur. The severity of the disease is diagnosed on the basis of general well-being, the degree of impairment and local manifestations.

Light degree gravity
It is characterized practically total absence common symptoms. The exception is a slight rise in body temperature to 37 or 37.5 degrees. The appearance of elements of the lesion is preceded by gingivitis or, in other words, inflammation of the gums. The elements of the lesion should be understood as bubbles in the amount of 3 to 4 pieces, which quickly open and form erosion. It is on such an erosive surface that fibrinous plaque is observed. In addition to what has already been said, it is also necessary to pay attention to the presence of signs of submandibular lymphadenitis.

Moderate severity
It is characterized by a significant increase in temperature, which ranges from 38 to 38.5 degrees. The patient is accompanied by:

• headache;
• weakness;
• malaise;
• nausea;
• loss of appetite.

There is strong salivation. The number of elements of the lesion includes about twenty foci, which appear not only on the mucous membrane, but also around the mouth. In the dominant case, signs of lymphadenitis and gingivitis appear.

Severe severity
It is characterized by initial, rather strong, violations of the general condition. The patient suffers from:

• muscle and headache;
• ailments;
• elevated body temperature (up to 40 degrees);
• nausea and vomiting (in some cases);
• lesions of the cervical and submandibular lymph nodes

In the process of damage, in addition to the mucous membrane of the oral cavity, the skin on the fingers, eyelids, and also the conjunctiva are affected. The most obvious place of localization is the mucous membrane of the lips, hard and soft palate, lip. Elements of the lesion are also present in the perioral region. All of them are arranged in groups and number more than 25 pieces.

General symptoms of herpetic stomatitis in children

Its harbinger is always an increase in temperature to 38 degrees. The child becomes moody and irritable. However, it is possible to suspect the disease only after a rash, which manifests itself on the second or third day of the disease. However, before the rash, there is a picture of intoxication, which is caused by enlarged lymph nodes and the presence of gingivitis in the oral cavity. From this, the gums swell and the child has an ajar mouth, which is why saliva constantly flows out. In turn, due to the disease, it becomes painful for him to swallow it. Especially pain increase during withdrawal.

Based on the fact that grouped small rashes open extremely quickly, forming painful sores, the child:

• refuses food;
• sleeps badly;
• constantly crying.

Formed, in the oral cavity, erosion quickly covers white coating. Over time, they self-clean and become covered with a layer of epithelium.

The choice of treatment tactics

Treatment will always depend on the severity of the disease. For the treatment of herpetic stomatitis in children are used:

• antiviral ointments;
• antiseptics, which are used three to four times a day.

If there is a positive trend, epithelializing drugs are additionally prescribed. However, it is worth noting that any manifestations of the disease disappear after seven days.

In the case of a moderate or severe form of the disease, not only local therapy is used, but also general therapy. Its essence lies in taking antiviral drugs, including valacyclovir or acyclovir, vitamins and immunocorrective agents.

Mandatory are:

1. Diet;
2. Bed rest;
3. Plentiful drink.

In case of manifestation of muscle and headaches, high temperature, it is used and symptomatic therapy, which consists in taking painkillers and antipyretics. For the treatment of emerging ulcers, the treatment of the surface of the affected areas with antiviral ointments, enzymes that accelerate epithelialization and enzymes is prescribed.

Important!!!

The approach to the treatment of herpetic stomatitis in children and adults is fundamentally different.

Forms of herpetic stomatitis

Regarding this disease, there is a classification into two forms:

• acute herpetic stomatitis;
• chronic recurrent stomatitis.

Acute herpetic stomatitis in children

It has five periods of development, namely:

1. incubation period;
2. prodromal period;
3. The period of the peak of the disease;
4. The extinction of her symptoms;
5. clinical recovery.

In children, acute herpetic stomatitis manifests itself against the background of primary infection with the herpes simplex virus due to a weakened immune system. Regarding the symptoms, we will not repeat, since it is described above.

Diagnosis of acute herpetic stomatitis

It presents a rather difficult task. As a rule, diagnosis is based on the use of special virological, immunological, molecular biological cytological and serological studies. A blood test confirms nonspecific changes that are characteristic of inflammatory process in its acute form. The pH level in saliva first shifts to the acid side, and then to the alkaline. It also shows a reduced content of lysocytim and the absence of interferon.

By using histological analysis characteristic intraepithelial arrangements of vesicles are found, namely in the subulate layers. Lenticular and ballooning degeneration and acantholysis are also observed in epithelial cells, and an acute inflammatory process is expressed in the mucous membrane.

In its turn cytological examination provides a different picture. Hestiocytes and neutrophils predominate. The presence of layers is noticeable epithelial cells, in which such a phenomenon as polymorphism, expressed in the form of syncytia, is very often observed. Also, characteristic giant multinucleated cells from 30 to 120 microns in diameter appear, which differ in size, color and shape by sharp polymorphism. As a rule, nucleoli are not observed, however, this does not indicate their absence, but their scarcity.

After the onset of clinical recovery, the herpes virus is not destroyed, but remains in the carrier's body throughout his life. In this regard, a person has non-sterile unstable immunity.

Treatment of acute herpetic stomatitis

Treatment is by combining antiviral therapy and eliminating the pain symptoms of the disease. Necessary condition treatment is the regular cleansing of the oral cavity from the accumulation of necrotic masses. In the case of a severe course of the disease, treatment is carried out in a hospital. For the speedy recovery and prevention possible relapses vitamins are used, and drugs that stimulate the immune system. The patient's condition is alleviated by plentiful drink and the complete exclusion of spicy and fried foods. Adults give up bad habits.

Chronic recurrent herpes

The line between acute stomatitis and recurrent is extremely thin. Recurrent herpes is characterized by multiple or solitary rashes on the lips or in the mouth, which in the latter case are localized in the sky. Perhaps their appearance on the wings of the nose, genitals or mucous membranes of the eyes. The rash is accompanied by a burning sensation, followed by the formation of a blistering rash and its transition to merged erosion. mouth discomfort and pain causes eating.

In the case of relapses of herpetic stomatitis, the provocateurs are a wide variety of microtraumas inflicted on the mucous membrane of the oral cavity in connection with bad habits, which include:

• chewing or biting cheeks, lips;
• biting the tongue;
• putting toys in your mouth.

Among the provocateurs are also:

• dental diseases;
• hypothermia;
• insolation.

Symptoms of chronic recurrent herpes

It proceeds like acute herpetic stomatitis, therefore special symptoms the disease does not.

Treatment of chronic recurrent herpes

During the period of exacerbation, there are no fundamental differences in treatment. Basically, decaris is prescribed in an amount of 50 mg. one to two times a day. The application period is five to ten days. In parallel, local treatment is also carried out to ensure the appearance of the so-called "light" long periods.

Causes of herpetic stomatitis in adults

As a rule, it manifests itself in those who have previously had this disease. The disease returns under the influence of the following factors:

• hypothermia;
• reduced immunity;
• SARS;
• exacerbation of inflammatory chronic diseases(sinusitis or tonsillitis);
• seasonal beriberi;
• allergic reactions;
• stress
• injuries of the mucous membrane, red border of the lips;
• medicines that lower the immune system.

The following reasons, which also affect the return of herpetic stomatitis, are:

• accumulation of calculus or soft plaque on the teeth;
• carious foci of teeth;
• untreated periodontitis or gigivitis;
• mouth breathing;
• chronic disease of the tonsils.

Treatment of herpetic stomatitis in adults

The basis of treatment is antiviral and immunostimulating agents. Vitamins are also used, which are prescribed taking into account a three-month intake to maintain immunity. Also used antiseptic solutions for rinsing the mouth. Symptomatic remedies are indispensable for combating high temperatures exceeding 38 degrees.

Important!!!
In the case of a temperature below this mark, a decrease in the production of interferon in the body is observed, which prevents the full formation of immunity.

It must be remembered that the disease is contagious. Therefore, it is advisable to avoid kissing, drinking drinks and food from the same container, use the same cutlery.

Alternative methods of treatment of herpetic stomatitis

At a time when medicine was not yet as popular as it is today, most of our ancestors treated themselves for the disease we are describing. So, for the treatment of herpetic stomatitis:

1. Pour a glass of boiling water 20 gr. chopped dry oak bark and leave it in a water bath for thirty minutes. After that, strain and bring the solution to an amount of 200 ml;
2. 5 gr. leaves walnut pour one glass of boiling water. Let it brew for thirty minutes and strain. Use 1 dessert spoon three times a day for the purpose of rinsing for 10 to 12 days;
3. IN boiled water add freshly prepared cabbage juice. The composition is a wonderful remedy against inflammatory processes.;
4. Stir two tablespoons of white birch, three tablespoons of knotweed and burnet, four tablespoons ordinary flax. Mix well. Take three tablespoons of the resulting mixture and pour one liter of boiling water. Take 3 ml. 7 times a day.

Multiple sores on the gums, tongue, lips, filled with liquid - this is acute herpetic stomatitis. The disease at least once in a lifetime was observed in 80% of people. Even with a single appearance of herpetic stomatitis, the patient remains at risk of recurrence of the disease for life. Therefore, it is important to know well the symptoms of the disease, the causes of its occurrence, as well as the main methods of treating stomatitis.

The development of the disease provokes the herpes simplex virus of the first type. The infection is transmitted from patient to patient mainly by airborne droplets, through household contact, and also transplacentally (from mother to child during childbirth). Children are more susceptible to the herpes virus three years as well as teenagers during hormonal adjustment organism.

The herpes virus can be in the human body for years and not make itself felt. Development acute phase diseases will be caused by factors such as reduced immunity, previous infections, mucosal injuries, metabolic disorders, hormonal imbalance.

Acute herpetic stomatitis

How does the acute form of herpes stomatitis manifest itself?

Symptoms of herpetic aphthous stomatitis depend on the form of the disease.

Light form acute herpetic stomatitis during the onset of the disease is accompanied by a slight increase in temperature, headache, loss of appetite. A day later, red foci of infection form on the mucous membrane, after another 2 days, rashes in the form of bubbles appear in the oral cavity. After 4 days, the blisters burst, small sores form on the mucosa, which quickly heal.

The average form begins with signs of general intoxication, which are accompanied by an increase in lymph nodes, an increase in temperature up to 39 degrees. Up to 25 vesicles form on the oral mucosa, which can merge into one formation with subsequent ulceration. When you brush your teeth, blood appears in your saliva.

Severe herpetic stomatitis observed mainly in the elderly and those with weakened immune systems. The disease begins with symptoms of toxicosis, swollen lymph nodes, swelling of the conjunctiva of the eyes. Two days after the onset of such symptoms, herpetic blisters form. They cover not only the shell of the mouth, but also the earlobes, fingers, and sometimes the mucous membrane of the eyes. Vesicles may merge into large areas of necrotic lesions. Patients with this form acute stomatitis admitted to hospital for treatment.

Clinical picture chronic stomatitis accompanied by pain in the joints, fever up to 38.5 degrees. Symptoms of the disease are less pronounced than in the acute form. The mild form of stomatitis worsens up to two times a year, the average one - up to four, the severe one has a continuous course with an increase in symptoms.

Treatment

Treatment of acute herpetic stomatitis involves local and general antiviral therapy, symptomatic medication, compliance bed rest during the first days of illness. Patients are advised to avoid hot, spicy and rough foods that can injure the mucous membrane. At the time of treatment, the patient is given a separate dish, isolated from social group. The duration of treatment is 2-3 weeks, depending on the severity of the disease and the patient's condition.

Medical treatment

Drug therapy for acute herpetic stomatitis in adults involves taking both local and generic drugs. As a general remedy, patients are prescribed:

1. Antiviral drugs in tablets: Acyclovir, Virolex, Famvir. Accepted up to seven days.
2. Antipyretic drugs. Used symptomatically.
3. Immunity boosters containing interferon. They are prescribed mainly to patients who have recently had another infectious disease.
4. Vitamin complexes containing ascorbic acid.
5. With manifestations of allergies - antihistamines- "Suprastin", "Claritin".

For local treatment the following means are used:

1. Solutions for rinsing the mouth: a weak solution of "Furacilin".
2. Lotions based on lidocaine.
3. Antiviral ointments: "Acyclovir", "Zovirax". Apply to the affected areas of the mucosa up to 5 times a day.
4. Epithelizing agents: rosehip oil, sea buckthorn oil, Solcoseryl.

Patients may also be given enzyme preparations to cleanse erosion from necrotic tissues. They are prescribed for severe form herpes.

Acute herpetic stomatitis in children - how to treat?

ethnoscience

To stop the symptoms of herpetic stomatitis, you can use folk remedies. The most effective of them are the following:

1. Healing ointment based on aloe. To prepare it, take a spoonful of aloe pulp and mix it in equal proportions with olive oil. The resulting mass is applied to the sores 3-5 times a day.
2. infusions lime blossom for rinsing. twenty grams pharmaceutical linden pour 200 grams of boiling water, leave to thaw for 6 hours, after which the solution is decanted, half a spoonful of soda is added and used for rinsing up to 3 times a day.
3. Healing ointment based on honey. To prepare the product, take a tablespoon of honey heated in a water bath, a tablespoon olive oil cold pressed, raw chicken protein and half an ampoule of a 0.5% solution of novocaine. All this is mixed until smooth and applied to the affected areas of the mucosa after rinsing. The tool has a pronounced healing and analgesic effect.
4. Infusion kombucha. Used to rinse the mouth every hour, it eliminates discomfort on the first day after the formation of blisters.

It should be remembered that the funds presented can only short term alleviate the patient's condition. It is not necessary to use them as the main treatment. If possible, you should immediately consult a doctor and proceed to antiviral therapy.

In general, the symptoms of herpetic aphthous stomatitis with correct selection therapeutic methods can be fixed in 2-3 weeks. The disease is not completely cured, since the herpes virus remains in the human body even after drug treatment. To prevent the onset of symptoms of the disease in the future, it is enough for a person to strengthen the immune system, as well as avoid contact with people suffering from an acute form of herpetic stomatitis.

One of the most common infectious inflammation affecting the oral mucosa in children is herpetic stomatitis. Almost all parents have to deal with this disease in their baby, and the most important thing is to take up treatment in time to prevent the transition of acute herpes stomatitis in a child into a chronic phase.

Acute herpetic stomatitis in children is caused by the herpes virus, which affects the oral mucosa and provokes a syndrome of general intoxication. The most vulnerable group of babies in the face of the disease is children aged one to three years, for whom infection with herpes is actually the first contact with this pathogen.

Acute herpetic stomatitis in children is caused by the herpes virus.

The children's body at this age is especially prone to many infectious diseases, including the herpes virus, which is associated with a number of objective reasons. Firstly, we are talking O specific features the structure of the body is small child, which is complemented by the loss of immunity inherited transplacentally from the mother.

It is worth adding here the fact that the baby’s own cellular immunity is not yet able to produce enough antibodies to fight viruses, which creates a favorable basis for pathogenic invasion.

Important! If a child during the first year of life was forced to artificial feeding He is also at risk.

Apart from acute form herpetic stomatitis can have and chronic giving occasional relapses. Having been ill with this disease, most babies acquire immunity to it and simply become carriers of the virus, but treatment should be taken very seriously: those whose disease has become chronic may subsequently suffer from diseases of the central nervous system or internal organs.

Causes

The main source of infection of the child with herpetic stomatitis are other children - sick or carriers.

The main source of infection of a child with herpetic stomatitis are other children - sick or carriers, since this virus is highly contagious. The route of transmission can be contact or airborne. In the first case, the pathogen is transmitted through the contact of a healthy child with an infected person or his things, toys, personal hygiene items.

In the second case, the transmission of herpes occurs after a sick baby coughs or sneezes next to a healthy one, but, one way or another, the infected child must be isolated before his full recovery. Unfortunately, failure to comply with this principle leads to stable high level epidemiological situation in relation to herpes, and most often the child becomes infected with it in kindergarten or clinic at large cluster children.

There are a number of factors that suppress resistance child's body and increase the risk of disease:

• hypothermia or overheating;
• prolonged exposure to solar radiation;
• avitaminosis;
• long courses of antibiotics (or immunosuppressants);
• ARVI diseases;
• stress.

The virus that enters the body first of all begins to actively multiply, infecting the epithelium and submandibular lymph nodes.

The virus that enters the body first of all begins to actively multiply, infecting the epithelium and submandibular lymph nodes, after which it enters the bloodstream with internal organs. There goes sharp rise its activity, which is reflected on the skin and mucous membranes in the form of symptoms typical of herpes.

Note! In case of an unfavorable development of events, the virus, having a neuroinvasive nature, can permanently gain a foothold in the body, hitting nervous system and causing the child to have meningitis or encephalitis.

Clinical picture

Usually, children suffer from herpetic stomatitis easily or relatively hard, although there are also complicated cases. Distinctive feature of this disease is the presence of a prodromal period - the time between incubation period and directly by the course of stomatitis. The virus can develop asymptomatically in the body of a child for up to two weeks, after which the first warning signs diseases: sleep and appetite disorders, capriciousness or restlessness.

Most parents, if they attach importance to this, then look for the cause in more simple and everyday factors, thereby losing precious time, during which it would be possible to begin treatment of herpes stomatitis in children. Following the described symptoms, more severe manifestations are added:

• nausea (up to vomiting);
• refusal of food;
• noticeable swelling of the lymph nodes in the neck.

Usually, children suffer from herpetic stomatitis easily or relatively hard, although there are also complicated cases.

At the end of the prodromal period, the disease reaches its peak of development, causing characteristic herpetic eruptions both on the mucous membrane of the mouth and on the lips (sometimes cheeks). Initially, this rash appears as vesicular vesicles. small size With thin walls And cloudy liquid inside. When they burst, they form erosive defects (or aphthae, more characteristic of aphthous stomatitis), which are small whitish ulcerations, very painful - especially during meals.

Inevitably, fever also occurs, accompanied by high - up to 40 degrees - temperature, as well as typical catarrhal symptoms like runny nose and cough. Sometimes conjunctivitis and are added to them, during which the gums swell and turn red (including bleeding).

The vesicular stage of stomatitis lasts about three to five days, and the erosions and ulcers after them heal on their own, leaving no traces. A complication of the disease with another infection can lead to suppuration of ulcers on the skin or in the mouth, which makes healing much more difficult.

Additional Information. With proper treatment and strong immunity the child will cope with herpetic stomatitis in a week, otherwise recovery will have to wait two to three weeks.

Treatment

The most revealing will be blood and saliva tests, as well as a smear.

Before starting the treatment of herpetic stomatitis in children, you must first make a correct diagnosis, on which the set of necessary therapeutic measures will depend. Apart from visual inspection and interviewing parents, the doctor will need to conduct a series of tests to confirm the diagnosis. The most revealing will be blood and saliva tests, as well as a smear made in the oral cavity - they will distinguish this type of stomatitis from its other varieties, as well as from diseases such as scarlet fever, diphtheria, herpetic sore throat and other infectious diseases.

In severe cases, the baby may need hospitalization, but usually everything is limited to providing proper home care based on several important principles:

• bed rest;
• plentiful drink;
• isolation from healthy children.

With regard to drug treatment, it is determined by the severity and variety of symptoms. To reduce the temperature, the doctor may recommend Paracetamol or Ibuprofen, to combat the herpes virus are effective on early stages diseases will be Acyclovir or Interferon. Puffiness is best eliminated with antihistamine drugs like Suprastin, Clemastine or Cetirizine, and to strengthen general health need to use immunocorrectors.

Puffiness is best eliminated with antihistamines.

Of course, you will need the organization and local treatment carried out by the dentist (or), which will consist in treating the oral mucosa with special antiseptic and antiviral drugs. If necessary, you can also use local anesthetics and mouthwash herbal infusions. The areas of the mucous membrane affected by erosion will need to be removed, for which the child will be prescribed proteases that eliminate necrotic plaque.

Subsequent healing of the epithelium will go faster if the baby will take vitamin complexes And vegetable oils. Finally, physiotherapy measures such as ultraviolet radiation or infrared radiation, which has anti-edematous and vasodilating effects.

Prevention

The best prevention is strengthening the immune system.

The main thing that parents need to remember is that it is impossible to avoid infecting a baby with the herpes simplex virus, since its prevalence is too high, even if for the most part the source of the disease is simply the carriers of the infection. For this reason, strengthening the general immunity of the child comes to the fore, for which doctors recommend resorting to regular exercise and hardening. It will not be superfluous to avoid the child being in enclosed spaces among a large number of people who can potentially transmit the virus (this is especially true in spring and autumn).

In general, with acute herpetic stomatitis in a child, the prognosis is favorable if the treatment was started on time, and the disease was not complicated by a secondary infection. The recovery process usually takes about 10-15 days, after which the baby receives immunity to this pathogen.

Parents must understand that they are responsible not only for their child, but also for those children with whom he contacts in nurseries. educational institutions, therefore, they are obliged to notify the other parents if their baby is sick. This will prevent the general spread of the infection and will make it possible to start treatment for other children in time.

Herpetic infections ORM Herpeviruses are divided into 3 subfamilies 1. Alphaherpevirus includes: - herpes simplex viruses 1 and 2 antigenic types - herpes zoster (herpes zoster) 2. Betagerpevirus (obstruction of the eyes, skin) 3. Gammaherpesvirus - o.herpetic stomatitis, HRAS recurrent lip herpes

Acute herpetic stomatitis (OSH) Occurs in children in 80% of cases of all stomatitis The most common at the age of 6 months - up to 3 years This is due to the disappearance of antibodies obtained in utero from the mother AHS can develop as a result of o. herpetic infection, and due to the reactivation of a latent virus.

Acute herpetic stomatitis (AHS) There is an opinion that the infectious principle is stored in the body not in the form of mature viral particles, but in the form of infectious DNA Latent viral start may persist in lymph nodes consistent with development clinical signs(lymphadenitis precedes severe forms of acute hepatitis C) The pathogen of acute hepatitis C is not well understood

Acute herpetic stomatitis (AHS) Clinic Occurs by type infectious disease and has 5 periods: incubation, prodromal, peak, extinction, recovery Incubation period: primary viremia is observed (virus release into the blood). Viruses settle in the liver, spleen, multiply, lesions occur by the type of necrosis

Acute herpetic stomatitis (AHS) Clinic There are mild, moderate and severe form Prodromal period (absent in mild form) - secondary viremia appears (viruses rush to the skin and mucous membranes where their intracellular reproduction continues). A state of immunosuppression develops due to a decrease in indicators natural immunity cellular nature.

Acute herpetic stomatitis (AHS) Clinic Prodromal period: The disease begins with intoxication - drowsiness, lethargy, nausea, vomiting, high fever, capricious children The height of the disease. Easy degree. Single elements of the rash appear on the mucosa, which quickly undergo reverse development.

Acute herpetic stomatitis (AHS) Clinic Light degree. Scheme of the evolution of the elements of the lesion Spot - a vesicle with transparent contents - a vesicle with turbid (fibrous) contents - an area of ​​epithelial necrosis according to the type of papule (plaque) - erosion - aphtha - spot At the same time, CG, lymphadenitis of the sub-slavic glands is observed The height of the disease is 1-2 days , extinction is longer. After epithelialization of the elements, it remains in the region of the front teeth of the CG No changes in the blood

Acute herpetic stomatitis (AHS) Clinic Moderate form. The symptoms of toxicosis and lesions of the oral mucosa are clearly expressed. Body temperature up to 39 °, sleep is disturbed, appetite ARI symptoms may develop Submandibular lymph nodes enlarged, painful During the height of b-ni at the peak of the rise in temperature, increased hyperemia and swelling of the mucosa, multiple elements of the lesion appear, which tend to recur and pour out even on the lip Pronounced gingivitis B blood ESR up to 2 ml/hour, lecophenia

Acute herpetic stomatitis (AHS) Clinic Moderate form. Pronounced gingivitis In the blood, ESR up to 2 ml / hour, healing. Deficit of cellular immunity. The duration of the extinction period depends on the body's resistance and the treatment being carried out. In the case of irrational treatment, the elements of the lesion merge, ulcerative gingivitis appears, bleeding gums and lymphadenitis persist longer. During the period of clinical recovery, there is no complete recovery of humoral and cellular factors immunity

Acute herpetic stomatitis (AHS) Clinic Severe form. Occurs less frequently. In the prodromal period, all signs of an acute infectious disease: a very severe headache and musculoskeletal hyperesthesia. Symptoms of CCC damage are observed: bradycardia or tachycardia, muffled tones, arterial hypotension Some children even have nosebleeds. Temperature up to 40° Rashes in the form of bubbles in the perioral region, eyelids, earlobes, conjunctiva of the eyes

Acute herpetic stomatitis (AHS) Clinic Severe form. Occurs less frequently. At the height of the disease are characteristic: A large number of elements of destruction Sharp putrid smell from the mouth Profuse salivation with an admixture of blood In the blood: leukopenia, stab shift to the left, eosinophilia Oral fluid: pH acidic or sharply alkaline, the content of lysozyme is reduced Immunity (humoral) is reduced Children need hospitalization

Acute herpetic stomatitis (AHS) Clinic Severe form. Occurs less frequently. Fading period Depends on the timely and proper treatment and availability concomitant diseases Every 7-8 child has relapses with the transition to a chronic relapsing form Children with this pathology are at risk The diagnosis of ACS is made on the basis of the clinical picture Laboratory research: virological, cytological, immunological.

Recurrent herpetic stomatitis (RGS) cellular immunity Decrease in immunoglobulins Immunosuppressive hematological disorders in blood diseases Use of immunosuppressants and steroids Local injuries Sun exposure Emotional and hormonal stress SARS, exacerbations respiratory tract Contact with a person who has symptoms of herpes Mucosal injury

Recurrent herpetic stomatitis (RGS) Clinic Relapses are accompanied by: Constant soreness of the mucous membrane in the affected areas Deterioration of the general condition, weakness Decreased appetite On the mucous membrane - changes in the form of areas of superficial necrosis of the epithelium without a corolla of hyperemia around - Elements of the lesion from 3 to 5 mm in diameter, arranged in groups

Principles of treatment of acute and recurrent herpetic stomatitis Specific antiviral agents local therapy: Florenal ointment 0.5% - effective for HSV (herpes simplex virus) Tebrofen ointment 0.5% effective for the virus, as well as HSV (herpes simplex virus) Interferon ointment 50% Oxalin ointment 0.25% for prophylactic and prodromal purposes period Bonafton ointment 0.05% - prevents the reproduction of the virus

Principles of treatment of acute and recurrent herpetic stomatitis Specific antiviral agents of local therapy: Adimalev ointment 0.5% virus-neutralizing ointment Ridoxol ointment 0.25 and 0.5% is active against influenza virus and HSV Deoxyribonuclease 1% solution delays intracellular reproduction of DNA-containing viruses

Principles of treatment of acute and recurrent herpetic stomatitis Herbal preparations antiviral action (mainly block HSV) Alpizarin - 5% ointment, tablets Gossypol (from cotton pigment) 3% liniment in orange jars of 20 g each Megosin (gossypol derivative) -3% megosin ointment

Principles of treatment of acute and recurrent herpetic stomatitis Herbal preparations of auxiliary therapy: Collanchoe juice - in ampoules and vials, as well as Calendula ointment - tincture and Kalefton ointment Buds and leaves of bearded birch - infusions and decoctions Scotch pine - buds and needles. Decoctions of Eucalyptus - infusions, tinctures, decoctions All preparations are used in the first hours and days of the development of the elements of the lesion for 3-4 days - applications, lubrication of areas, rinsing the mouth

Principles of treatment of acute and recurrent herpetic stomatitis Antiviral therapy general action Bonafton – 1 t. Per day. The course of treatment is 10 days Alpizarin inside, 1 tab. (0.1 g) 3 times a day. Course of treatment 1-15 days Lysozyme intramuscularly 100 mg 2 times a day. Course of treatment - 20 injections

Principles of treatment of acute and recurrent herpetic stomatitis Means of antiviral therapy of general action Interferon (from donor blood). V / m 500 mg (1 ml) 1 time in 3-4 days. Course of treatment 4-5 injections Combination of interferon together with inducers of interferonogens (prodigiosan, gammaglobulin, levamisole) - Prodigiosan (polysaccharide) as an anti-relapse therapy. V / m, starting with a dose of 0.3 ml 1 time in 5 days, increasing to 1 ml. Only 7 injections.

Principles of treatment of acute and recurrent herpetic stomatitis Means of antiviral therapy of general action Levamisole (decaris) - reduces the period of exacerbation and increases the stage of remission in CHD. 150 mg per day after meals, 3 days in a row with a 4-day break, 5-6 weeks Gammaglobulin is involved in the production of antibodies. I/m 1.5 ml of proteo-measles or 3 ml of anti-staphylococcal - with an interval of 3-4 days between injections, per course - 6 injections Specific antiherpetic gamma globulin from placental blood - 1.5 mg intramuscularly every 1 day. Course 6 injections