Episode Details

- 12.31.24

Quick Review #259 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #herpangina #coxsackievirus #herpes #herpeticstomatitis

Coxsackievirus Herpangina

• Causative Agent: Coxsackievirus (commonly group A).

• Population Affected: Primarily affects children, especially during summer and early fall.

Oral Manifestations:

• Small vesicles (2-4 mm) on the soft palate, uvula, tonsillar pillars, and posterior pharynx.

• Vesicles rupture to form shallow ulcers with surrounding erythema.

• Rarely involves the anterior oral cavity or gingiva.

Symptoms:

• Sudden onset of high fever (101-104°F).

• Sore throat and difficulty swallowing (dysphagia).

• Headache, abdominal pain, and vomiting are common.

Systemic Signs:

• Malaise and fatigue.

• Mild rash on the hands, feet, and other body areas may occur in hand, foot, and mouth disease, but less pronounced in herpangina.

• Duration: Resolves within 7-10 days without scarring.

• Transmission: Fecal-oral route or respiratory droplets.

Herpetic Stomatitis

• Causative Agent: Herpes simplex virus (HSV-1, primarily).

• Population Affected: Most common in young children (primary infection), but can affect adults in recurrent forms (e.g., cold sores).

Oral Manifestations:

• Multiple vesicles and ulcers throughout the oral cavity, including the gingiva, lips, tongue, buccal mucosa, and palate.

• Gingival involvement leads to diffuse erythema, swelling, and bleeding (gingivostomatitis).

• Vesicles rupture to form painful ulcers.

Symptoms:

• Painful oral lesions interfere with eating and drinking.

• Fever (mild to moderate) and lymphadenopathy.

Systemic Signs:

• Cervical lymphadenopathy is common.

• Irritability and malaise, especially in children.

• Possible dehydration due to difficulty eating and drinking.

• Duration: Resolves in 10-14 days. May result in latent infection in the trigeminal ganglion, causing recurrent herpes labialis.

• Transmission: Direct contact with saliva or vesicular fluid

References:

1. The Royal Children’s Hospital Melbourne. (n.d.). HSV gingivostomatitis: Clinical practice guidelines. Retrieved December 30, 2024, from https://lnkd.in/e2ywfghm

2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2022). Oral and maxillofacial pathology (5th ed.). Elsevier.

3. Kumar, V., Abbas, A. K., & Aster, J. C. (2021). Robbins and Cotran pathologic basis of disease (10th ed.). Elsevier.

4. Terezhalmy, G. T., & Riley, C. K. (2023). Viral infections of the oral cavity: Clinical manifestations and management. Journal of Oral Medicine and Oral Surgery, 29(3), 205-212

5. ChatGPT. 2024

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