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How successfully do general practitioners diagnose herpetic gingivo-stomatitis clinically?
Alexander Kiderman1, Arthur L Furst, T Miller
1Division of Family Medicine, The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Summary
Herpetic gingivo-stomatitis in children can be reliably diagnosed by general practitioners. This supports using antiviral medication like aciclovir in primary care without lab tests, improving treatment access.
Area of Science:
- Pediatric infectious diseases
- General practice and primary care
- Virology
Background:
- Herpetic gingivo-stomatitis is a frequent, painful condition in young children.
- Aciclovir is effective for hospital-treated cases, but its use in general practice is limited by diagnostic challenges.
- Laboratory diagnosis is often impractical in primary care settings.
Purpose of the Study:
- To evaluate the accuracy of clinical diagnoses of herpetic gingivo-stomatitis made by general practitioners (GPs).
- To determine if clinical diagnosis alone is sufficient for initiating aciclovir treatment in primary care.
Main Methods:
- 27 GPs made clinical diagnoses of herpetic gingivo-stomatitis.
- Laboratory virus culture was used to validate these clinical diagnoses.
- Positive predictive value (PPV) was calculated for the clinical diagnoses.
Main Results:
- 49 out of 63 clinical diagnoses were confirmed by laboratory culture.
- The positive predictive value of clinical diagnosis was 78%.
- This indicates a high level of diagnostic accuracy in general practice.
Conclusions:
- Clinical diagnosis of herpetic gingivo-stomatitis by GPs is sufficiently accurate.
- Aciclovir treatment can be safely initiated in primary care based on clinical diagnosis alone.
- This approach can improve timely access to effective treatment for affected children.