Herpetic stomatitis is caused by infection with herpes simplex virus type 1 (HSV-1). It commonly occurs in infants and young children aged 1 to 3 years and can spread easily in public settings. The condition shows no significant seasonal variation in incidence.
Clinical Manifestations
Lesions frequently appear on the buccal mucosa, gums, tongue, the inner lips, vermilion border, and adjacent perioral skin. The onset typically involves fever, which can reach 38–40°C, followed 1–2 days later by the development of small vesicles, either isolated or clustered, on the oral mucosa in the affected areas. These vesicles measure approximately 2 mm in diameter, are surrounded by erythema, and rupture quickly to form ulcers covered with a yellowish-white fibrinous exudate. Multiple ulcers may coalesce into irregularly shaped larger ulcers, occasionally affecting the soft palate, tongue, and throat. Severe pain often causes children to refuse food, drool excessively, and become irritable, with crying during feeding or meals commonly the first noticed symptom. Body temperature typically normalizes within 3–5 days, and the disease course lasts about 1–2 weeks. Regional lymph nodes are often enlarged and tender, and this lymphadenopathy may persist for 2–3 weeks.
Differentiation from herpangina is important. Herpangina, caused by Coxsackie A virus, often occurs during the summer and autumn seasons, and its onset is characterized by sudden fever and sore throat. Physical examination reveals pharyngeal congestion along with gray-white vesicles surrounded by an erythematous halo on the mucosa of the tonsillar pillars, soft palate, and uvula. After vesicle rupture, ulcers are formed. Importantly, herpangina does not involve the gums or buccal mucosa, distinguishing it from herpetic stomatitis.
Treatment
Maintaining oral hygiene and ensuring adequate fluid intake, with a preference for lukewarm or cool liquid-based foods, is recommended while avoiding irritative foods. Topical agents like watermelon frost spray or tin powder may be applied locally. In cases of severe pain, a 2% lidocaine solution may be applied to the affected areas before meals. Fever can be managed with antipyretic medications. Antibiotics do not shorten the course of the disease and are reserved for cases with secondary bacterial infections.