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inflammation of the mucous membrane of the mouth

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/12 15:37:28」(JST)

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Gingivostomatitis (also known as primary herpetic gingivostomatitis or orolabial herpes) is a combination of gingivitis and stomatitis, or an inflammation of the oral mucosa and gingiva.^[1] Herpetic gingivostomatitis is often the initial presentation during the first ("primary") herpes simplex infection. It is of greater severity than herpes labialis (cold sores) which is often the subsequent presentations. Primary herpetic gingivostomatitis is the most common viral infection of the mouth.^[2]

Primary herpetic gingivostomatitis (PHGS) represents the clinically apparent pattern of primary herpes simplex virus (HSV) infection, since the vast majority of other primary infections are symptomless. PHGS is caused predominantly by HSV-1 and affects mainly children. Prodromal symptoms, such as fever, anorexia, irritability, malaise and headache, may occur in advance of disease. The disease presents as numerous pin-head vesicles, which rupture rapidly to form painful irregular ulcerations covered by yellow–grey membranes. Sub-mandibular lymphadenitis, halitosis and refusal to drink are usual concomitant findings.^[3]

Symptoms

Herpes lesions on the gingiva.^[4]

The symptoms can be mild or severe and may include:

Not able to chew or swallow
Sores on the inside of the cheeks or gums
Fever
General discomfort, uneasiness, or ill feeling
Very sore mouth with no desire to eat
Halitosis (bad breath)

Differential Diagnosis

Gingivostomatitis symptoms in infants may wrongly be dismissed as teething. "Coincidentally, primary tooth eruption begins at about the time that infants are losing maternal antibody protection against the herpes virus. Also, reports on teething difficulties have recorded symptoms which are remarkably consistent with primary oral herpetic infection such as fever, irritability, sleeplessness, and difficulty with eating."^[5] "Younger infants with higher residual levels of antibodies would experience milder infections and these would be more likely to go unrecognized or be dismissed as teething difficulty."^[6]

Gingivostomatitis must also be differentiated from herpangina, another disease that also commonly causes ulcers in the oral cavity of children, but is caused by the Coxsackie A virus rather than a herpes virus.^[7] In herpangina, ulcers are usually isolated to the soft palate and anterior pillar of the mouth.^[7] In herpetic gingivostomatitis, lesions can be found in these locations, but they are almost always accompanied by ulcerations on the gums, lips, tongue or buccal mucosa and/or by hyperemia, hypertrophy or hemorrhage of the gums.^[7]

Treatment

Treatment includes fluid intake, good oral hygiene and gentle debridement of the mouth. In healthy individuals the lesions heal spontaneously in 7–14 days without scarring.

References

^ "Gingivostomatitis" at Dorland's Medical Dictionary
^ "Oral Complications of Cancer and Its Management". By Andrew Davies, Joel Epstein. Oxford University Press, 2010. p195
^ "Herpes simplex virus infection, with particular reference to the progression and complications of primary herpetic gingivostomatitis", A. Kolokotronis, S. Doumas, Clinical Microbiology and Infection, Volume 12, Issue 3, pages 202–211, March 2006. http://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2005.01336.x/full
^ Dorfman, J. The Center for Special Dentistry.
^ "Herpetic gingivostomatitis and teething difficulty in infants". David L. King, William Steinhauer, Franklin Garcfa-Godoy, Cassandra J. Elkins. PEDIATRIC DENTISTRY MARCH/APRIL, 1992 VOLUME 14, NUMBER 2. p83
^ "Herpetic gingivostomatitis and teething difficulty in infants". David L. King, William Steinhauer, Franklin Garcfa-Godoy, Cassandra J. Elkins. PEDIATRIC DENTISTRY MARCH/APRIL, 1992 VOLUME 14, NUMBER 2. p84
^ ^a ^b ^c PARROTT, RH; WOLF, SI; NUDELMAN, J; NAIDEN, E; HUEBNER, RJ; RICE, EC; McCULLOUGH, NB (August 1954). "Clinical and laboratory differentiation between herpangina and infectious (herpetic) gingivostomatitis.". Pediatrics 14 (2): 122–9. PMID 13185685. |access-date= requires |url= (help)

External links

Underlying Causes at wrongdiagnosis.com
CDC Case Definition: Mercury (Elemental)

UpToDate Contents

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1. 若齢小児におけるヘルペス性歯肉口内炎 herpetic gingivostomatitis in young children
2. 免疫正常患者における単純ヘルペスウイルス1型感染の治療 treatment of herpes simplex virus type 1 infection in immunocompetent patients
3. 口腔病変 oral lesions
4. 小児における口腔軟部組織病変 soft tissue lesions of the oral cavity in children
5. 単純ヘルペスウイルス1型感染の臨床症状および診断 clinical manifestations and diagnosis of herpes simplex virus type 1 infection

English Journal

The impact of oral herpes simplex virus infection and candidiasis on chemotherapy-induced oral mucositis among patients with hematological malignancies.

Chen YK, Hou HA, Chow JM, Chen YC, Hsueh PR, Tien HF.SourceGraduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology.Eur J Clin Microbiol Infect Dis.2011 Jun;30(6):753-9. Epub 2011 Jan 12.
The aim of this study was to evaluate the influences of oral candidiasis and herpes simplex virus 1 (HSV-1) infections in chemotherapy-induced oral mucositis (OM). The medical records of 424 consecutive patients with hematological malignancies who had received chemotherapy at a medical center in Tai
PMID 21225303

Japanese Journal

Analgesic effect of dexmedetomidine in a patient with herpetic stomatitis after living-donor lung transplantation

OHASHI YOSHIFUMI,OHTA NORIYUKI,HIRAO OSAMU,UCHIYAMA AKINORI,MASHIMO TAKASHI,FUJINO YUJI
Journal of anesthesia 22(3), 297-299, 2008-08-20
NAID 10021942747