Differential Diagnoses. Powerpoint Templates Page 1 Powerpoint Templates Gingival Swellings Differential diagnosis Amer Ali College of dentistry, university of Kufa 2. Primary herpetic gingivostomatitis is an infection of the oral cavity caused by the herpes simplex virus type 1 (Figure 11-11). In the primary infection, the virus ascends through sensory and autonomic nerves, where it persists as latent HSV in neuronal ganglia. Ziskin and Holden 11 reported 8 cases of acute herpetic gingivostomatitis in adults, and Florman and Trader 12 a case in an adult. Definition (MSH) Herpes simplex, caused by type 1 virus, primarily spread by oral secretions and usually occurring as a concomitant of fever. synonyms. Gingivostomatitis may be caused by a virus or bacteria or it may be the result of poor oral hygiene. The differential diagnosis of primary herpetic gingivostomatitis includes acute necrotizing ulcerative gingiv itis, herpangina, aphthous stomatitis, candidiasis of the mouth, Steven-Johnson syndrome and hand, foot and mouth disease. Differential diagnosis: ANUG can be easily misdiagnosed for primary herpetic gingivostomatitis, which is caused by herpes simplex virus 32. higher grade (look ill) Vesicles. Ulcerations; larger than in viral enanthems. Differential Diagnosis. There was no definitive treatment, and the infection was self-limiting within 2 to 3 weeks. Herpes simplex gingivostomatitis ( jin-juh-voe-sto-ma-tie-tis) is inflammation of the gums and lips caused by the herpes virus the same virus that later causes cold sores. What you need to know. Erythema multiforme. In the ED, the diagnosis of herpetic gingivostomatitis is clinical, although numerous laboratory tests are available to aid in confirming the diagnosis. Basic metabolic panel and liver function tests were normal. Erythrocyte sedimentation rate was mildly elevated at 36mm/hr. Differential Diagnosis (Other conditions with similar appearance Allergies Non-viral canker sore Sores around mouth or on genitals Viral cultures or blood test can confirm diagnosis. Differential Diagnosis. Sometimes pronounced general symptoms such as fatigue, vomiting, fever. In the ED, the diagnosis of herpetic gingivostomatitis is clinical, although numerous laboratory tests are available to aid in confirming the diagnosis. Local and systemic granulomatous diseases must be considered in the differential diagnosis. "Acute herpetic gingivostomatitis associated with herpes simplex virus 2: report of a case." The majority of primary infections are asymptomatic, occurring without any signs of cutaneous disease. Primary Type 1 HSV most often presents as gingivostomatitis, in children between 1 and 5 years of age. Citation: Tilliss TSI, McDowell JD. The diagnosis can be confirmed by viral culture or direct fluorescent antibody studies when necessary. may be subclinical cervical lymphadenopathy; limbs not involved. The differential diagnosis of herpetic gingivostomatitis includes herpangina and hand, foot and mouth disease, both of which are usually caused by coxsackieviruses, in addition to aphthous stomatitis, candidiasis of the mouth and Steven-Johnson syndrome. The clinical features, diagnosis, management, and prevention of herpetic gingivostomatitis will be discussed here. The clinical features, diagnosis, management, and prevention of herpetic gingivostomatitis will be discussed here. This inflammation damages the skin, resulting in painful ulcers in the mouth and blisters on the lips. The clinical presentation, course, differential diagnosis and management of AHGS are discussed. Appointments & Locations. Lymphadenopathy. It commonly occurs in children, but it can affect adults too. Primary herpetic gingivostomatitis is the most common viral infection of the mouth. Nongenital herpes simplex virus type 1 (HSV-1) is a common infection that most often involves the oral mucosa or lips (herpes labialis). Is characterized by acute onset of fever, malaise, pain, and ulceration of both gingiva and oral mucosa. Differential diagnosis: (1) herpetic gingivostomatitis (2) chickenpox HFMD. Differential Diagnosis. How to cite the article: George AK, Anil S. Acute herpetic gingivostomatitis associated with herpes simplex virus 2: Report of a case. The virus is transmitted by direct contact with infected lesions or from saliva, which may remain infectious for several months. Local and systemic granulomatous diseases must be considered in the differential diagnosis. Differential diagnosis. ulcerations. Pine Nut, great ideas! The differential diagnosis for childhood rashes and oral enanthems is broad and includes erythema multiforme, herpes, measles, and varicella. Unknown. Search: Herpetic Whitlow Or Dyshidrotic Eczema. Herpetic Gingivostomatitis . This investigation was conducted to determine whether primary herpetic gingivostomatitis may be responsible for those signs and symptoms commonly attributed to teething in infants. The Mosby; 1997:73-74, 167-168. Lips, gingiva, buccal mucosa. oral mucosa and lips. Hand, foot and mouth disease - lesions may also be seen on the hands or feet. A diagnosis of herpetic gingivostomatitis was made, and she was prescribed oral acyclovir, paracetamol and topical anaesthetic gel. Temperature generally high. HERPES SIMPLEX VIRUS Print Section Listen HERPETIC GINGIVOSTOMATITIS Primary herpetic gingivostomatitis is caused by herpes simplex virus 1 (HSV-1) infection in children and characterized by painful vesicular lesions of the mouth. initial infection of primary herpetic gingivostomatitis (PHG) primarily affects children under 10 years of age with a peak incidence at 2-4 years of age, and secondarily young adults, aged 15 to 25 years (1,2) Incubation period of HSV infection ranges approximately 3 to 10 days. 2020 Sep;15 (3):386-387. doi: 10.1016/j.jds.2020.06.001. Despite the largely based clinical diagnosis of herpetic gingivostomatitis, it is important first to rule out other diseases that present similarly, keeping in mind the age group and past medical history of the patient. J Int Oral Health 6(3): 99-102. Differential diagnosis. Conclusions: Primary herpetic gingivostomatitis is not limited to children but can affect people of any age. Appointments 216.444.8500. Herpetic gingivostomatitis is a manifestation of herpes simplex virus type 1 (HSV-1) and is characterized by high-grade fever and painful oral lesions. Differential diagnosis. Differential diagnosis of herpes simplex gingivostomatitis: Aphthous ulcers - do not cause fever; lesions are more likely to be on non-keratinised mucosa. Hand, foot and mouth disease - lesions may also be seen on the hands or feet. Herpes zoster of the second or third division of the trigeminal nerve. Most cases of primary herpetic gingivostomatitis arise between ages 6 months and 5 years, with a second age-related peak in patients ages 20 to 29 years. Sometimes pronounced general symptoms such as fatigue, vomiting, fever. Primary herpetic gingivostomatitis is characterized by ulcerative lesions of the gingiva and mucous membranes of the mouth , often with perioral vesicular lesions (picture 2A-B). Painful swelling of the regional lymph nodes. Gingivostomatitis symptoms in infants may wrongly be dismissed as teething. The differential diagnosis of herpetic gingivostomatitis in a child includes herpangina, hand-foot-and-mouth disease, aphthous stomatitis, Behet syndrome, pemphigus vulgaris, and StevensJohnson syndrome. A lesion caused by type 1 or type 2 herpes simplex virus, involving the oralfacial region. It is of greater severity than herpes labialis (cold sores) which is often the subsequent presentations. Gums are enlarged, red, and painful. Primary herpetic gingivostomatitis (PHGS) typically has a prodrome of 2-4 days, and consists of fever, malaise, headaches, and cervical lymphadenopathy before generalised gingival inflammation and ulceration occur. Herpes Gingivostomatitis HSV 1 and HSV 2. Viral culture was confirmed as the gold standard for diagnosis. Most common in 1-3 year olds. I am leaving to visit with the dermatologist soon It is a rare condition in immunocompetent patients, and usually Tenderness and erythema on the lateral nail fold Post-herpetic neuralgia more frequent in patients over the age of 50 Dyshidrotic Eczema Dyshidrotic eczema can also be a Herpetic whitlow Herpes simplex virus (HSV) is the causative agent for acute primary herpetic gingivostomatitis. 4). Herpes gingivostomatitis was suspected. Features of primary herpetic gingivostomatitis include, but are not limited to, fever, anorexia, malaise, lymphadenopathy, headache, nausea, vomiting, gingivitis (with markedly swollen, erythematous and friable tissue), and vesicular lesions. 1. Primary infection occurs approx 1 week after contact w/ infected individual. cervical lymphadenopathy; limbs not involved. Since not all oral sores are benign, a careful differential diagnosis is important. Course Number: 110. Should be offered to all children with herpetic gingivostomatitis because of the degree of pain most suffer herpetic gingivo-stomatitis. It usually occurs as acute herpetic stomatitis (or gingivostomatitis), an oral manifestation of primary herpes simplex seen primarily in children and adolescents. Herpetic gingivostomatitis (HGS) and herpetiform aphthous ulcerations (HAU, also known as herpetiform type recurrent aphthous stomatitis) are two oral diseases with different etiologies and oral manifestations. herpetic gingivo-stomatitis. 1, 2, 3, 4, 5 However, they are easily confused because the two disease names contain a similar adjective, herpetic or herpetiform. It causes trademark localised blistering on and around the mouth (cold sores), and the genital area in some cases. A Tzank smear specimen (obtained from scraping the ulcer base of an unroofed lesion) may demonstrate the typical features of an intracellular viral infection with a ground-glass appearance to the nuclear chromatin and multinucleated giant cells. 1 HSV-1 is primarily responsible for oral mucosal infections, while HSV-2 is implicated in most genital and cutaneous lower body lesions. A diagnosis of herpetic gingivostomatitis was made, and she was prescribed oral acyclovir, paracetamol and topical anaesthetic gel. Keywords: Herpes, lesion, primary herpetic gingivostomatitis, aphthous stomatitis, RIH, RAS, recur-rent intraoral herpes, recurrent aphthous stomatitis, ulcer, canker sore, cold sore, fever blister. involve hands and palms, less centrally. Given the patients age, and the severity of the presentation, there was concern for an underlying immunocompromised state. Treatments may include antibiotics or minor oral surgery. While herpetic gingivostomatitis most commonly occurs in children from ages 6 months to 5 years, it may also occur in adults. This case study also emphasises the importance for oral Primary herpetic gingivostomatitis is a common paediatric infection and the causative organism in 90% of cases is herpes simplex virus type 1, with complications that range Moderate to severe. Differential diagnosis The initial primary differential diagnosis for our patient included: chemotherapy induced mucositis, neutropenic mucositis, HSV, gingivostomatitis, HIV-associated periodontitis and invasive fungal disease. oral mucosa and lips. Gingivostomatitis (also known as primary herpetic gingivostomatitis) is a combination of gingivitis and stomatitis, or an inflammation of the oral mucosa and gingiva. Orofacial herpes simplex infections (also known as cold sores, fever blisters, or herpetic gingivostomatitis) are very common viral infections causing pain, vesicles, ulceration, and crusting of the perioral skin and oral mucosa. buccal mucosa and tongue. Transmission is by direct contact of lesions or oral secretions. herpangina and other viral lesions are reported as the main differential diagnosis of acute herpetic gingivostomatitis.2,9 Besides that, It is important to distinguish primary from recurrent herpetic infection by the history and previous episodes of vesicular eruptions on their lips.10 In the case reported, other viral infections were Differential diagnosis The initial primary differential diagnosis for our patient included: chemotherapy induced mucositis, neutropenic mucositis, HSV, gingivostomatitis, HIV-associated periodontitis and invasive fungal disease. Keywords: Herpes, lesion, primary herpetic gingivostomatitis, aphthous stomatitis, RIH, RAS, recur-rent intraoral herpes, recurrent aphthous stomatitis, ulcer, canker sore, cold sore, fever blister. Gingivitis with inflammatory reddened, swollen, slightly bleeding mucosa. The lip lesions of primary herpetic gingivostomatitis may bear a resemblance to the crusted lip lesions of EM (Fig. A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions. The incidences of NUG in industrialized countries are primarily in young adults and rarely prior to adolescence while primary herpetic gingivostomatitis is diagnosed primarily in children. Coxsackie virus infections (hand-foot and mouth disease, herpangina) Aphthous ulcers; Oral candidiasis; Stevens-Johnson syndrome. Gingivitis with inflammatory reddened, swollen, slightly bleeding mucosa. Gingivostomatitis is an infection of the mouth. The incidences of NUG in industrialized countries are primarily in young adults and rarely prior to adolescence while primary herpetic gingivostomatitis is diagnosed primarily in children. Lips, tongue, buccal mucosa; generally not diffuse. Proper diagnosis and treatment are essential, particularly in elderly and immunocompromised patients. Differential diagnosis of oral ulcerations with special emphasis on the diagnosis, etiology and management will be presented in a case-based format.