Viral Infections of the mouth

Oral Manifestations of Viral Infections:-

¨ Coxsackie/ECHO viruses

- Ulcers in herpangina and in hand, foot and mouth disease

¨ Cytomegalovirus

- Ulcers

- Sialadenitis

¨ Epstein-Barr virus (infectious mononucleosis)

- Sore throat, tonsillar exudate, palatal petechiae, cervical lymph node enlargement, ulcers, lymphoma, sialadenitis, recurrent parotitis-possibly in children

¨ Herpes simplex

- Ulcers and gingivitis in primary infection; Vesicles on lips in recurrence – Herpes Labialis (rarely oral ulcers), lymph node enlargement, facial palsy, erythema multiforme

¨ Herpes zoster-Varicella

- Ulcers in chicken pox, or in zoster of trigeminal maxillary or mandibular divisions; pain in maxillary or mandibular zoster; facial palsy in Ramsay-Hunt syndrome of zoster of geniculate ganglion

 

 

 

 

 

 

 

 

 

 

¨ Human herpes virus 8

Kaposi sarcoma

 

 

 

 

 

 

 

 

¨ Measles

- Koplik’s spots

¨ Mumps

- Salivary gland swelling

¨ Papilloma viruses

- Warts, papillomas, focal epithelial hyperplasia

¨ Human immunodeficiency virus (HIV causing AIDS)

 

Lymph node enlargement, infections, particularly herpetic and candidal; ulcers, kaposi sarcoma, lymphoma, hairy leukoplakia, parotitis, xerostomia, purpura, cranial nerve lesions, periodontitis

 

 

 

 

 

 

 

 

Rubella

Palatal petechiae; dental hypoplasia in congenital rubella

 

Diagnosis

The clinical picture is usually distinctive. Confirmation of diagnosis (if required) by serology.

Treatment

Mainly symptomatic. In cases of severe primary herpetic stomatitis, herpes labialis and herpes zoster Acyclovir can be helpful. Unusually prolonged or severe infections, or failure to respond to acyclovir suggests immunodeficiency, and herpetic ulceration persisting for more than a month is an AIDS-defining illness.

 

Viral infections affecting children:

 

1. Primary herpetic gingivostomatitis (Aciclovir 200-400mg/day – only if caught early) SEE picture on right

2. Secondary herpes labialis

3. Hand, foot and mouth disease

4. Herpangina

5. Warts

All form vesicles or ulceration.

Self-limiting. Supportive treatment— soft diet and plenty of fluids.