Acute herpetic stomatitis: causes, symptoms, treatment. Traditional methods of treating herpetic stomatitis

Are you familiar with the feeling of burning and itching on your lips? Or the unexpected appearance of 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. 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, popularly called HERPES. Namely, let's consider herpetic stomatitis, etiology, pathogenesis, clinic and treatment of this disease.

ETIOLOGY OF HERPETIC STOMATITIS

The etiology of herpetic stomatitis is simple. If there is a virus, there are diseases. The virus causing herpetic stomatitis belongs to the family HERPESVIRIDAE. This family includes about 80 various viruses, and, attention, 8 of which are causes of human illness. Herpetic stomatitis is caused by a virus herpes simplex Type 1 (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, has come up with 4 ways of entering the human body:

• Airborne (therefore, it is recommended to avoid people with visible manifestations of the virus);
• Contact (lips affected by herpes are unlikely to 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 and not fully understood. It is not fully explained what factors dissolve the inner shell of the virus, what viral factors allow it to penetrate 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 (cells that are sensitive to HSV). Then the fusion of the cell membrane and the outer shell of the virus occurs. At the moment of such penetration cell membrane the cells are not damaged, but the virus seems to bud 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 the herpes simplex virus can be in this state long time, until the provoking factors work.

FACTORS PROVOKING RECURRENCE OF HERPETIC STOMATITIS

Factors that provoke relapse of herpetic stomatitis are: large group. In principle, herpes can be triggered by anything, from climate change and time zone to ARVI and other infections. AND yes, to the group Factors that provoke a relapse of herpetic stomatitis include:

• Any change in body temperature (the herpetic stomatitis virus prefers hypothermia);
• Decreased immunity (any infection, etc.);
• Trauma to mucous membranes and skin;
• Stress, overwork or overexertion;
• Consumption of alcoholic beverages;
• Smoking;
• Menstruation;
• Change of climate and time zone;
• Taking medications.

As you can see 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 get sick due to the cessation 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 has had symptoms of herpes, but also before birth. That is, work should be carried out with parents both by an obstetrician-gynecologist and a dentist. The most simple rules prevention of herpetic stomatitis are:

• Use of masks;
• Careful hand hygiene;
• Uses individual funds hygiene;
• Individual dishes, towels, etc.;
• Bans on kissing;
• Prohibition on tasting food;
• General cleaning of the premises;
• Ventilation;
• Hardening the body;
• Good nutrition;
• Physical activity;
• Timely treatment of common diseases.

But if you or your child 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 involve taking interferon.

SYMPTOMS OF HERPETIC STOMATITIS

Knowing the symptoms of herpetic stomatitis is very helpful for timely treatment. That is, it is possible to prevent bright clinical picture.

Symptoms of herpetic stomatitis:

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

These, you know, are common symptoms that are precursors to the appearance of herpes. However, in the development of herpetic stomatitis there are 4 stages, each of which has 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 disease is prodromal period (it is at this stage that the general symptoms of herpetic stomatitis are observed. Remember that symptoms may vary depending on the severity of the disease, it is written about it below)

Third stage - development period - this is also the period of rashes.

Fourth stage – extinction period — the mucous membrane and skin are restored, and the state of health also returns to normal.

CLASSIFICATION OF HERPETIC STOMATITIS

Classification of herpetic stomatitis includes:

• Acute herpetic stomatitis;
• Chronic recurrent herpetic stomatitis;
• Herpetic geometric glossitis;
• Gladiator herpes;
• Acute herpetic infection in newborns;
• Chronic herpetic infection with manifestation in the oral cavity in certain immunodeficiency conditions.

Herpetic stomatitis is also:

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

ELEMENTS OF HERPETIC STOMATITIS

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

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

When the mucous membrane of the oral cavity is affected, there are some peculiarities. It all starts with a spot, which then turns into a vesicle (bubbles, as I said, can be either with transparent contents or with cloudy content), after the vesicle erosion occurs (hyperemic, painful, sensitive to irritants, an open area of ​​the mucous membrane), which will turn into aphtha ( formation with a rim of redness along the edge of the element, whitish inside). And then again the stain and restoration.

ACUTE HERPETIC E SKY STOMATITIS

Acute herpetic stomatitis occurs for the first time. And the severity of the infection (from mild to severe) depends, firstly, on the aggressiveness of the virus itself, and secondly, on the host’s immunity. Therefore, in some cases, the infection goes away on its own, as if “self-limiting”: after two weeks, 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.

Let's consider each form of acute herpetic stomatitis.

1. Mild form of acute herpetic stomatitis

The 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.

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

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

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

• By reducing all elements of the lesion in size, their healing occurs (epithelialization),
• Normalization of the size of lymph nodes;
• Normalization of body temperature;
• Reducing mucosal hyperemia
• The period is longer.

2) Moderate form of herpetic stomatitis

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

• Appearance of weakness, sleep disturbances, appetite disorders;
• Increased body temperature to 37.5 degrees;
• Increased size of lymph nodes.

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

• Chills, weakness, headache;
• Increased body temperature 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 period of extinction is characterized by:

• Recovery general well-being;
• Normalization of the size of 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.

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

• Apathy;
• Headache;
• Can be observed on the skin - muscle changes type of hyperesthesia;
• Cardiovascular changes 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 in the neck.

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

• Body temperature is more than 39 degrees;
• The oral mucosa is swollen and hyperemic;
• There is dryness of the lips, possible cracking;
• The number of damage elements is more than 100!
• Ulcerative gingivitis;
• Increased salivation with blood.

The 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 of chronic recurrent herpetic stomatitis is determined not by the number of lesions (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 every 3 years;

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 blisters, which then appear, forming erosions. The mucous membrane is swollen and hyperemic. In severe cases of chronic recurrent herpetic stomatitis, a deterioration in the patient’s general well-being is added, headache, weakness, body temperature more than 39 degrees.

DIFFERENT DIAGNOSTICS OF HERPETHIC 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 both lesions have aphthae. However, with aphthous stomatitis they are single, round, covered with a whitish coating and surrounded by a halo of hyperemia, there is no catarrhal gingivitis, The lymph nodes not enlarged and absent elevated temperature bodies.

The differences between herpetic stomatitis and exudative erythema begin with the time of year. Most often, erythema occurs in autumn and spring and immediately begins to become difficult. That is, it is characterized by total damage to the mucous membrane, hyperemia, and edema. Erosions and ulcers are large, massive hemorrhagic crusts on the red border of the lips, cracks. The general condition also suffers: body temperature more than 40 degrees, weakness, malaise, multiple bluish spots (cockades) on the skin of the hands.

The difference with pemphigus vulgaris is that with pemphigus there are erosions that are slightly painful, located on the visually healthy mucous membrane of the oral cavity.

TREATMENT OF HERPETIC STOMATITIS

Treatment of herpetic stomatitis can be general or local. Depending on the severity of herpetic stomatitis this treatment can be combined.

General treatment boils down to the following:

• High-calorie diet, drinking plenty of warm water;
• Antiviral drugs orally, intravenously or intramuscularly for moderate and 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 supplements, means to increase the body’s immune defense such as ginseng, eleutherococcus)
• Sodium salicylate can be used as an analgesic, antipyretic and anti-inflammatory agent;
• Gamma globulin, immunal, lysozyme are prescribed in cycles;
• When choosing tactics general treatment you need to correctly determine the form of the disease!

Local treatment comes down to rinsing the mouth with an antiseptic (can be combined with an anesthetic), applications of antiviral ointments, gels that are not only antiviral, but also stimulate the local immune response, enzymatic preparations, drugs to accelerate epithelization, astringents.

During the inter-relapse period, they resort to using daily acyclovir 200 mg 2 to 5 times a day for 1 to 3 years.

Be attentive to yourself and others, don’t get sick! Thanks for reading!

The article was written by N. Shidlovskaya. Please, when copying material, do not forget to provide a 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 oral mucosa and is caused by the herpes simplex virus. Occurs in children from six months to three years. A child becomes infected through airborne infection from a virus carrier or a sick person, as well as through sexual contact. As a rule, the soil for the disease is prepared by weakened immunity.

Classification of herpetic stomatitis

According to the course of the disease there are:

• spicy;
• chronic recurrent.

Based on severity:

• light;
• medium-heavy;
• 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 based on general health, the degree of impairment and local manifestations.

Mild degree gravity
Characterized practically complete absence common symptoms. The exception is a slight increase in body temperature to 37 or 37.5 degrees. The appearance of lesions is preceded by gingivitis, or in other words, inflammation of the gums. The elements of damage should be understood as bubbles in the amount of 3 to 4 pieces, which quickly open and form erosions. It is on such an eroded 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 lesions totals 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, quite strong, disturbances in 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 addition to the mucous membrane of the oral cavity, the lesion affects the skin of the fingers, eyelids, and conjunctiva. The most obvious place of localization is the mucous membrane of the lips, hard and soft palate, lips Elements of the lesion are also present in the perioral area. All of them are located 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 capricious and irritable. However, it is possible to suspect the disease only after a rash, which appears on the second or third day of the disease. However, before the rash, a picture of intoxication is observed, caused by enlarged lymph nodes and the presence of gingivitis in the oral cavity. This causes the gums to swell and the child’s mouth remains slightly open due to which saliva constantly flows out. In turn, due to the disease, it becomes painful for him to swallow it. Especially painful sensations increase during rash.

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

• refuses food;
• sleeps poorly;
• cries constantly.

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

Choice of treatment tactics

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

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

If positive dynamics are observed, epithelializing drugs are also prescribed. However, it is worth noting that any manifestations of the disease disappear after seven days.

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

Mandatory are:

1. Diet;
2. Bed rest;
3. Drink plenty of fluids.

In case of muscle pain, headaches, high temperature, it is also used. symptomatic therapy, which consists of taking painkillers and antipyretics. To treat emerging ulcers, treatment of the surface of the affected areas with antiviral ointments, enzymes that accelerate epithelization and enzymes is prescribed.

Important!!!

The approach to the treatment of herpetic stomatitis in children and adults is radically 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 height of the disease;
4. Fading of her symptoms;
5. Clinical recovery.

In children, acute herpetic stomatitis occurs against the background of primary infection with the herpes simplex virus due to a weakened immune system. We will not repeat the symptoms, since they are described above.

Diagnosis of acute herpetic stomatitis

It is quite a 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 acidic side and then to the alkaline side. It also reveals a reduced content of lysocythyme and the absence of interferon.

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

In its turn cytological examination provides a different picture. Gestiocytes and neutrophils predominate. The presence of layers is noticeable epithelial cells, in which the phenomenon of polymorphism, expressed in the form of syncytia, is very often observed. Characteristic giant multinucleated cells from 30 to 120 microns in diameter also appear, which differ in size, color and shape by sharp polymorphism. As a rule, nucleoli are not observed, however, this does not mean 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 a non-sterile, unstable immunity.

Treatment of acute herpetic stomatitis

Treatment is carried out by a combination of antiviral therapy and elimination of painful symptoms of the disease. A necessary condition Treatment is regular cleansing of the oral cavity from the accumulation of necrotic masses. In case of severe disease, treatment is carried out in a hospital setting. For the purpose of a speedy recovery, as well as prevention possible relapses vitamins and drugs that stimulate the immune system are used. The patient's condition is alleviated with the help of drink plenty of fluids and complete exclusion of spicy and fried foods. Adults give up bad habits.

Chronic recurrent herpes

The line between acute stomatitis and recurrent stomatitis is extremely thin. Recurrent herpes is characterized by multiple or single rashes on the lips or mouth, which in the latter case are localized on the palate. They may appear 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 fused erosion. Discomfort in the mouth and painful sensations causes food intake.

In the case of relapses of herpetic stomatitis, the provocateurs are a wide variety of microtraumas inflicted on the oral mucosa due to bad habits, which include:

• chewing or biting cheeks, lips;
• tongue biting;
• putting toys in 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. Decaris is usually prescribed in an amount of 50 mg. from one to two times a day. The period of application is from five to ten days. At the same time, local treatment is carried out to ensure the appearance of so-called “light” long-term gaps.

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;
• ARVI;
• exacerbation of inflammatory chronic diseases(sinusitis or tonsillitis);
• seasonal vitamin deficiency;
• allergic reactions;
• stress;
• injuries to the mucous membrane, red border of the lips;
• medications that reduce immunity.

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

• accumulation of stone or soft plaque on the teeth;
• carious lesions of teeth;
• untreated periodontitis or hygiivitis;
• 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 to combat high temperatures exceeding 38 degrees.

Important!!!
If the temperature is below this mark, there is a decrease in the production of interferon in the body, 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, and using the same cutlery.

Traditional methods of treating herpetic stomatitis

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

1. Pour 20 grams of boiling water over it. crushed dry oak bark and leave it in a water bath for thirty minutes. After this, strain and bring the solution to a quantity 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 to rinse for 10 to 12 days;
3. IN boiled water add freshly cooked 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 ulcers on the gums, tongue, lips, filled with liquid - this is acute herpetic stomatitis. The disease was observed in 80% of people at least once in their lives.

Even with a one-time occurrence of herpetic stomatitis, the patient remains at risk of relapse 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 is provoked by the herpes simplex virus type 1. 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 under age are more susceptible to the herpes virus three years , as well as teenagers during hormonal changes

body. The herpes virus can remain in the human body for years and not make itself felt. Development acute phase

The disease will be caused by factors such as decreased immunity, past infections, mucosal injuries, metabolic disorders, and hormonal imbalance.

How does the acute form of herpes stomatitis manifest?

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, and loss of appetite. After a day, red foci of infection form on the mucous membrane, and after another 2 days, rashes in the form of blisters appear in the oral cavity. After 4 days, the blisters burst, small ulcers form on the mucous membrane, which quickly heal.

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

Severe herpetic stomatitis It is observed mainly in older people and people with weakened immune systems. The disease begins with symptoms of toxicosis, enlarged lymph nodes, and swelling of the conjunctiva of the eyes. Two days after the onset of such symptoms, herpetic blisters form. They cover not only the lining of the mouth, but also the earlobes, fingers, and sometimes the mucous membrane of the eyes. The blisters may coalesce into large areas of necrotic lesion. Patients with this form acute stomatitis are placed for treatment in a hospital.

Clinical picture chronic stomatitis accompanied by joint pain and fever up to 38.5 degrees. Symptoms of the disease are less pronounced than in the acute form. A mild form of stomatitis worsens up to two times a year, a moderate form - up to four times, a severe form has a continuous course with increasing symptoms.

Treatment

Treatment of acute herpetic stomatitis involves local and general antiviral therapy, taking symptomatic medications, compliance bed rest in the first days of the disease. Patients are advised to avoid hot, spicy and rough foods, which can injure the mucous membranes. During treatment, the patient is given a separate container and is isolated from social group. The treatment period is 2-3 weeks depending on the severity of the disease and the patient’s condition.

Drug treatment

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

1. Antiviral drugs in tablets: Acyclovir, Virolex, Famvir. Accepted up to seven days.
2. Antipyretic drugs. Used symptomatically.
3. Immune boosters containing interferon. Prescribed mainly to patients who have recently suffered from another infectious disease.
4. Vitamin complexes containing ascorbic acid.
5. In case of allergies - antihistamines- “Suprastin”, “Claritin”.

For local treatment the following means are used:

1. Solutions for rinsing the mouth: weak solution of “Furacilin”.
2. Lidocaine-based lotions.
3. Antiviral ointments: Acyclovir, Zovirax. Apply to the affected areas of the mucosa up to 5 times a day.
4. Epithelializing agents: rosehip oil, sea buckthorn oil, Solcoseryl.

Patients may also be prescribed enzyme preparations to cleanse erosions from necrotic tissue. They are prescribed for severe form herpes.

Acute herpetic stomatitis in children - how to treat?

ethnoscience

To relieve the symptoms of herpetic stomatitis, you can use folk remedies. The most effective of them are considered to be:

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 linden color for rinsing. Twenty grams pharmaceutical linden pour 200 grams of boiling water, leave to sit for 6 hours, after which the solution is decanted, half a spoon 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 0.5% novocaine solution. All this is mixed until smooth and applied to the affected areas of the mucous membrane after rinsing. The product has a pronounced healing and analgesic effect.
4. Infusion kombucha. Used to rinse the mouth every hour, it helps eliminate 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. There is no need to use them as the primary treatment. If possible, you should immediately consult a doctor and start antiviral therapy.

In general, the symptoms of herpetic aphthous stomatitis with correct selection therapeutic methods can be eliminated in 2-3 weeks. The disease cannot be completely cured, since the herpes virus remains in the human body even after drug treatment. To prevent the appearance 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 start treatment in a timely manner in order to prevent the transition of acute herpes stomatitis in a child to the chronic phase.

Acute herpetic stomatitis in children is caused by the herpes virus, which affects the mucous membrane of the oral cavity and provokes a syndrome of general intoxication. The most vulnerable group of children to the disease are 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.

A child’s body at this age is especially susceptible to many infectious diseases, including the herpes virus, which is associated with a number of objective reasons. Firstly, we're talking about O specific features the structure of the body is so 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 also falls into the risk group.

Besides acute form herpetic stomatitis can also have chronic nature, giving relapses from time to time. Having had this disease, most children 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 a child with herpetic stomatitis are other children - patients or carriers.

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

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

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

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

Once the virus enters the body, it first begins to actively multiply, infecting the epithelium and submandibular lymph nodes.

Once the virus enters the body, it first begins to actively multiply, infecting the epithelium and submandibular lymph nodes, after which it enters the bloodstream into internal organs. It's happening there sharp increase its activity, which is reflected on the skin and mucous membranes in the form of symptoms typical of herpes.

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

Clinical picture

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

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

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

Typically, children suffer from herpetic stomatitis easily or relatively severely, although complicated cases also occur.

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

Fever inevitably occurs, accompanied by a high temperature of up to 40 degrees, as well as typical catarrhal symptoms like runny nose and cough. Sometimes conjunctivitis and conjunctivitis are added to them, during which the gums become swollen and red (including bleeding).

The vesicular stage of stomatitis lasts about three to five days, and erosions and ulcers after them heal on their own, leaving no traces. Complication of the disease with another infection can lead to suppuration of ulcers on the skin or in the mouth, which will significantly complicate healing.

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

Before starting treatment for herpetic stomatitis in children, you must first make a correct diagnosis, on which the set of necessary therapeutic measures will depend. Besides visual inspection and interviewing parents, the doctor will need to conduct a series of tests to confirm the diagnosis. The most revealing tests 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;
• drinking plenty of water;
• isolation from healthy children.

As for drug treatment, it is determined by the severity and variety of symptoms. To reduce the temperature, the doctor may recommend Paracetamol or Ibuprofen, which are effective in combating the herpes virus. early stages diseases will be Acyclovir or Interferon. Swelling is best eliminated with antihistamines like Suprastin, Clemastine or Cetirizine, and to strengthen general health the use of immunocorrectors will be required.

Swelling is best treated with antihistamines.

Of course, you will need to organize local treatment carried out by a dentist (or), which will consist of treating the oral mucosa with special antiseptic and antiviral drugs. If necessary, it is also possible to use local anesthetics and mouth rinse 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 it will go faster if the baby takes vitamin complexes And vegetable oils. Finally, physiotherapeutic 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 their 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 child’s general immunity comes to the fore, for which doctors recommend resorting to regular physical exercise and hardening. It would be a good idea to avoid keeping your child in confined spaces among a large number of people who could 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 treatment was started on time and the disease is not complicated by a secondary infection. The recovery process usually takes about 10–15 days, after which the baby gains immunity to this pathogen.

Parents must understand that they are responsible not only for their child, but also for those children with whom he comes into contact in the nursery. educational institutions, therefore, they are obliged to notify other parents if their baby gets sick. This will prevent the widespread spread of infection and will make it possible to start treatment for other children in a timely manner.

Herpetic infections of the oral mucosa Herpeviruses are divided into 3 subfamilies 1. Alphaherpesvirus includes: -herpes simplex viruses of 1 and 2 antigenic types -herpes zoster (herpes zoster) 2. Betaherpesvirus (eye, skin) 3. Gammaherpesvirus - o.herpetic stomatitis, HRAS , recurrent herpes of the lips

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

Acute herpetic stomatitis (AHS) There is an opinion that the infectious principle persists in the body not in the form of mature viral particles, but in the form of infectious DNA Latent viral onset may persist in lymph nodes, which is consistent with development clinical signs(lymphadenitis precedes severe forms of AGS) The pathogen of AGS has not been studied enough

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

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, children are capricious. The height of the disease. Mild degree. Single elements of the rash appear on the mucous membrane, 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 cloudy (fibrous) contents - an area of ​​epithelial necrosis like a papule (plaque) - erosion - aphtha - a spot At the same time, CG is observed, lymphadenitis of the substellar glands Height of the disease 1-2 days , extinction is longer. After epithelialization of the elements, they remain in the area of ​​the front teeth of the CG. There are no changes in the blood.

Acute herpetic stomatitis (AHS) Clinic Moderate form. Symptoms of toxicosis and damage to the oral mucosa are clearly expressed. Body temperature up to 39°, sleep and appetite are disturbed. Symptoms of acute respiratory infections may develop. Submandibular lymph nodes enlarged, painful During the height of pain, at the peak of the rise in temperature, increased hyperemia and swelling of the mucous membrane, multiple lesions appear, which tend to recur and erupt even on the lip. Pronounced gingivitis B blood ESR up to 2 ml/hour, lecopenia

Acute herpetic stomatitis (AHS) Clinic Moderate form. Pronounced gingivitis In the blood, ESR is up to 2 ml/hour, lecopenia. Deficiency of cellular immunity. The duration of the extinction period depends on the body’s resistance and the treatment performed. In 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, the restoration of humoral and cellular factors immunity

Acute herpetic stomatitis (AHS) Clinic Severe form. Less common. During the prodromal period, all signs of an acute infectious disease: very severe headache and musculocutaneous hyperesthesia. Symptoms of CVS damage are observed: bradycardia or tachycardia, muffled sounds, arterial hypotension Some children even have nosebleeds. Temperature up to 40° Rashes in the form of blisters in the perioral area, eyelids, earlobes, conjunctiva of the eyes

Acute herpetic stomatitis (AHS) Clinic Severe form. Less common. At the height of the disease are characteristic: A large number of elements of damage Sharp putrid smell from the oral cavity Excessive drooling with an admixture of blood In the blood: leukopenia, band shift to the left, eosinophilia Oral fluid: pH acidic or sharply alkaline, lysozyme content is reduced Immunity (humoral) is reduced Children require hospitalization

Acute herpetic stomatitis (AHS) Clinic Severe form. Less common. Extinction period Depends on timely and proper treatment and availability concomitant diseases Every 7-8 children have relapses with the transition to a chronic recurrent form. Children with this pathology are at risk. The diagnosis of AGS is made based on the clinical picture Laboratory research: virological, cytological, immunological.

Recurrent herpetic stomatitis (RGS) The occurrence of relapses is facilitated by: Deviations in the humoral and cellular immunity Reduction of immunoglobulins Immunosuppressive hematological disorders in blood diseases Use of immunosuppressants and steroids Local injuries Solar irradiation Emotional and hormonal stress ARVI, acute exacerbations respiratory tract Contact with a person with symptoms of herpes Trauma to the mucous membrane

Recurrent herpetic stomatitis (RGS) Clinic Relapses are accompanied by: Constant pain of the mucous membrane in the affected areas Deterioration of general condition, weakness Decreased appetite On the mucous membrane - changes in the form of areas of superficial necrosis of the epithelium without a rim 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 against HSV (herpes simplex virus) Tebrofen ointment 0.5% effective against the virus, as well as HSV (herpes simplex virus) Interferon ointment 50% Oxaline ointment 0.25% for prophylactic purposes and prodromal period Bonaftone ointment 0.05% - prevents the reproduction of the virus

Principles of treatment of acute and recurrent herpetic stomatitis Specific antiviral agents for local therapy: Adimal ointment 0.5% virus-neutralizing ointment Ridoxol ointment 0.25 and 0.5% is active against influenza virus and HSV Deoxyribonuclease 1% solution delays the 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, Gossypol tablets (from cotton plant 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 bottles, as well as Calendula ointment - tincture and ointment "Calefton" Buds and leaves of bearded birch - infusions and decoctions Scots pine - buds and needles. Eucalyptus decoctions - infusions, tinctures, decoctions All drugs are used in the first hours and days of development of the lesion elements for 3-4 days - applications, lubrication of areas, mouth rinse

Principles of treatment of acute and recurrent herpetic stomatitis Antiviral therapy general action Bonafton - 1 t. 3 times a day (not chewed). Course of treatment - 10 days DNase - 500 mg intramuscularly on saline 1 r. Per day. The course of treatment is 10 days Alpizarin orally, 1 tablet (0.1 g) 3 times a day. The course of treatment is 1-15 days Lysozyme 100 mg intramuscularly 2 times a day. Course of treatment - 20 injections

Principles of treatment of acute and recurrent herpetic stomatitis General antiviral therapy Interferon (from donor blood). 500 mg (1 ml) IM once every 3-4 days. Course of treatment: 4-5 injections Combining interferon with interferonogen inducers (prodigiosan, gammaglobulin, levamisole) - Prodigiosan (polysaccharide) as anti-relapse therapy. IM, starting with a dose of 0.3 ml once every 5 days, increasing to 1 ml. A total of 7 injections.

Principles of treatment of acute and recurrent herpetic stomatitis General antiviral therapy Levamisole (decaris) - shortens the period of exacerbation and increases the remission stage in RHS. 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. IM 1.5 ml of anti-measles or 3 ml of anti-staphylococcal - with an interval of 3-4 days between injections, per course - 6 injections. Specific antiherpetic gammaglobulin from placental blood - 1.5 mg IM every 1 day. Course of 6 injections