Information From Your Health Care Provider

STOMATITIS, HERPETIC

Basic information

description

Herpetic stomatitis is a contagious, viral infection of the mouth that causes blisters, ulcers (open sores), and inflammation. This infection is not the same as canker sores. Herpetic stomatitis occurs most often in young children who have never had the virus before. It is a common and usually mild condition.

FREQUENT SIGNS & SYMPTOMS

Burning, tingling, or pain in the mouth.
Fever.
Blisters in the mouth, often on the tongue or cheeks .
Ulcers form after the blisters pop.
Swollen gums.
Drooling.
Difficulty swallowing (dysphagia) and eating.
Irritability.
May have bad breath, sore throat, or swollen glands in the neck.

causes

Herpes simplex virus type 1 (HSV-1). This is the same herpes virus that causes cold sores, but not the one that is spread by having sex. The virus enters the body when the mouth comes in contact with saliva from someone who is infected by the virus. Usually, no source for the infection will be discovered. Once the first infection occurs, the virus remains inside the body for life.

risk increases with

Exposure to someone who has herpetic stomatitis.
Physical contact with someone who has blisters or ulcers around the mouth.

PREVENTIVE MEASURES

It is difficult to prevent children from exposure to the virus at some time during their childhood.
Children should avoid close contact with anyone who has cold sores (e.g., don't kiss a parent who has a cold sore).
Children should also avoid other children with herpetic stomatitis. They should not share silverware, cups or glasses, or food with actively infected people.

expected outcomes

It will clear up on its own. Ulcers and other symptoms are generally healed within 10 to 14 days.

possible complications

High fever.
Dehydration (if a child refuses to eat or drink enough because of a sore mouth).
Infection recurs (will appear as cold sores).
Herpes eye infection (rare).

diagnosis & treatment

general measures

Some people will let the sores heal on their own.
See your health care provider if sores persist, cause excess pain, or cause concern. An exam of the mouth is usually all that is needed for diagnosis. Medical tests such as smears or cultures of the sores may be done.
Treatment may include temporary diet changes, extra rest, drugs for pain and fever, or antiviral drugs.
Wash your hands and the child's hands often, and especially before eating.
Avoid touching the mouth sores and then touching the eyes. It can lead to a serious herpes eye infection.

medications

Antiviral drugs (e.g., acyclovir) may be prescribed.
Use ibuprofen or acetaminophen for minor pain. Don't give aspirin to children under age 18.
Nonprescription topical anesthetics may relieve more severe pain. Follow product instructions carefully.

activity

Activity limits will depend on severity of symptoms. Extra rest is usually recommended when a child has a fever.

diet

Give a child cool liquids. They can be soothing to the mouth and help numb the pain. Choices include milk, milkshakes, and clear liquids. Use a straw if there are blisters on the lips or end of the tongue.
Avoid citrus or carbonated drinks. These can make the sores hurt more.
Feed the child soft foods to make chewing and swallowing easier. Choices include soft fruits, mashed potatoes, applesauce, yogurt, pudding, or strained baby foods. Avoid spicy, salty, or hard foods.

notify our office if

You or a family member has symptoms of herpetic stomatitis that cause concern.
Symptoms don't improve with treatment.
Your child will not drink and cannot swallow, has a high temperature, becomes more fussy or won't stop crying, or isn't better in a few days.