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The natural history of primary herpes simplex type 1 gingivostomatitis in children
1Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva.
Insights
Herpetic gingivostomatitis, a primary herpes simplex virus type 1 infection, commonly affects children. This study details its clinical signs, symptoms, and complications like dehydration.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Oral Medicine
Background:
- Herpetic gingivostomatitis is the most frequent clinical presentation of primary herpes simplex virus (HSV) infection in children.
- Understanding its clinical course and complications is crucial for effective management.
Purpose of the Study:
- To prospectively describe the clinical signs, symptoms, viral shedding, serologic findings, and complications of community-acquired herpetic gingivostomatitis in children.
- To characterize the natural history of herpes simplex virus type 1 (HSV-1) gingivostomatitis.
Main Methods:
- Prospective follow-up of 36 children (12-77 months) diagnosed with HSV-1 gingivostomatitis.
- Regular clinical examinations and viral cultures to assess lesion duration and viral shedding.
- Monitoring for complications such as dehydration and secondary infections.
Main Results:
- Mean duration of oral lesions was 12 days, with extraoral lesions in 26 children also lasting 12 days.
- Viral shedding of HSV-1 persisted for a mean of 7.1 days in all participants.
- Key complications included dehydration requiring hospitalization in three children and one case of secondary bacteremia.
Conclusions:
- Herpetic gingivostomatitis is a significant manifestation of primary HSV-1 infection in young children.
- The condition can lead to severe complications, including dehydration and secondary bacterial infections, necessitating prompt medical attention.
Abstract:
Herpetic gingivostomatitis is the most common specific clinical manifestation of primary herpes simplex infection in childhood. The aim of the present study was to describe the clinical signs, symptoms, viral shedding, serologic findings, and complications in community-acquired gingivostomatitis. We prospectively followed children with herpes simplex type 1 gingivostomatitis lasting less than 72 hours. Clinical examination and viral culture were repeated every 2 to 3 days as long as symptoms or signs persisted. Thirty-six children (ages 12-77 months) were included in the study. Mean duration of oral lesions was 12.0+/-3.4 days; extraoral lesions (in 26 children), 12.0 +/-3.9 days; fever, 4.4+/-2.4 days; and eating/drinking difficulties, 9.1+/-3.0 and 7.1+/-3.1 days, respectively. In all children, viral cultures of the oral lesions were positive for herpes simplex virus (HSV) type 1; viral shedding persisted for a mean of 7.1+/-2.5 days (range 2-12 days). The main complications were dehydration, with three children hospitalized for intravenous rehydration, and one case of secondary bacteremia. Herpetic gingivostomatitis is a relatively severe manifestation of primary HSV type 1 infection in young children.