The general symptoms of a primary infection include fever, malaise, and headache.
Herpetiform vesicles can be detected on the buccal mucosa, lips, and tongue; the vesicles often break and result in a small erosion.
The gingivae are red, swollen, and often bleeding. The mouth is extremely sore, and the child may not want to eat.
The patient recovers spontaneously: the fever disappears after the fourth day, and the vesicles resolve a couple of days later.
Acyclovir is beneficial if the treatment is started during the first days after onset.
Herpangina and hand-foot-and-mouth disease
The causative agents belong to the genus of enteroviruses. The most common organism causing hand-foot-and-mouth disease is coxsackievirus A16 Enterovirus Infections. The diseases usually occur in late summer and early autumn.
The disease is usually mild. The symptoms are milder than in stomatitis caused by herpes virus. Unlike herpes infections, enteroviral infections rarely cause gingivitis (gum bleeding). The general symptoms include fever, mouth pain, and unwillingness to eat.
The condition is characterized by recurring painful ulcers in the mouth in an otherwise healthy child, usually 1 to 5 ulcers at a time.
The aetiology is unknown. E.g. stress, anaemia or certain food stuffs may act as predisposing factors. In some cases, toothpastes containing sodium lauryl sulfate may trigger off the condition.
Give NSAIDs as solutions or rectal suppositories for fever and pain.
Local anaestetic gels and solutions usually containing lidocaine are available (special regulations for prescription may apply). They must be used cautiously in small children so as not to exceed the maximum lidocaine dose (3 mg/kg/24 h orally).
Occasionally viral stomatitis becomes prolonged, resulting in a disturbance of fluid and electrolyte balance so that hospitalization is necessary.